A Study of Papillary Muscles of the Left Ventricle in the Adult Human Cadavers

Abstract

Normal valve function depends upon the anatomic and mechanical integrity of the atrioventricular ring, the valve leaflets, the chordae tendineae and papillary muscles. Papillary muscle rupture and dysfunction can lead to complications of prolapsed mitral valve and mitral regurgitation. Materials and Methods: The material for present study consisted of 50 formalin fixed adult apparently normal cadaveric hearts belonging to either sex obtained from the Department of Anatomy, Govt. Medical College, Amritsar. These hearts were dissected to open the left ventricle and to expose the papillary muscles. Different morphological features of papillary muscles were noted and measurements were taken. Results: The anterolateral papillary muscle usually said to be single bellied was found so in majority of the hearts (86%) being double bellied in the rest of 14% hearts. However, the posteromedial papillary muscle usually said to be double bellied was found so only in 56% of the hearts, being 3 bellied in 20%, 4 bellied in 10% & single bellied in 14%. Negligible text is available about the number of heads of papillary muscles. It varied from 1-6 and 1-5 in anterolateral & posteromedial papillary muscles respectively which is another notable variation. Different shapes and pattern of papillary muscles have also been identified. An additional divison of study was measurement of lengths of papillary muscles which thus provides a base line data for further detailed studies based upon a larger data base. Conclusion: In this study, observations of more number of bellies of anterolateral papillary muscle and posteromedial papillary muscle instead of the only twos, are important and demand a modification in standard textbooks of anatomy. Notable variations of papillary muscles are important for scientists worldwide in order to ascertain the reason behind each specific architechtural arrangement. This will enable the cardio thoracic surgeons to tailor the surgical procedures according to the individual papillary muscle pattern.

Cadaveric Study on the Morphology and Morphometry of Heart Papillary Muscles

“…In our study, the right and left ventricles of all 50 hearts were found to contain three and two papillary muscles, respectively. Most anatomy textbooks indicate the existence of two papillary muscles in the left ventricle, which is well in accordance with the findings of our study as well as the one conducted by Shree et al [ 12 ]. In rare situations, Oosthoek et al and Madu et al reported an extra papillary muscle lying near to the apex [ 18 - 19 ].…”

“…The shape of the papillary muscles has an important role in smooth blood flow. In most textbooks, papillary muscles are characterized as conical in form, which is best adapted to facilitate cardiovascular physiology by obstructing the blood flow as little as possible [ 12 ]. In our study, the most common shape we came across among papillary muscles of right ventricles was conical: 42% in anterior, 36% in posterior, and 100% in septal papillary muscles.…”

“…The shape of the posterior papillary muscle in the right ventricle was observed to be conical in 36% (18) cases; fan shaped in 24% (12), and broad apexed and pyramidal in 20% (10) cases each. While among the left ventricles, the shape of the posterior papillary muscle was seen to be fan-shaped in the majority of cases (38% ( 19)), as represented by Figure 4.…”

“…Papillary muscles in the left ventricle are believed to be sensitive indicators of myocardial ischemia since they are the last part of the heart receiving blood supply from coronary arteries [ 12 ]. This was also mentioned by Waller et al in their study on the anatomy of the heart [ 7 ].…”

Cardiac Computed Tomography Assessment of the Variation of Papillary Muscle Morphology before Mitral Valve Surgery

“…Te papillary muscles are one of the components of the mitral valve and typically consist of two papillary muscle groups, the anterior papillary muscle group and the posterior papillary muscle group, with various morphological diversities. Several previous studies have reported the morphological evaluation of papillary muscles in donated hearts [1][2][3][4][5][6][7][8][9]. However, these studies were conducted on normal hearts, and hearts with diseases, such as mitral regurgitation (MR), have rarely been investigated.…”