The clinical anatomy of the mitral valve

Abstract

As a result of the numerous clinical and surgical data accumulated so far, the classical image of the mitral valve-a bicuspid valve, with two leaflets and two papillary muscles-undergoes significant modifications. The valve, included into the larger concept of the mitral valvular complex unveils numerous important valences and characteristics, among which, some represent newer concepts, of clinical and surgical significance: the valvular complex is a subtle and finely-tuned system of elements acting in a coordinated manner; the mitral valve is an active valve and not a mere passive flap bordering the atrioventricular junction. Not least, the mitral valve contributes to the make up and function of the left ventricular outflow tract. The anatomical and functional interdependence between the mitral valve and the left ventricular myocardium is evident not only following their particularities of vascularization but also it is reflected in morbid states such as ischemic cardiac disease and dilated cardiomyopathy. All the new concepts and ideas, ask for a more profound study of the clinical anatomy of the mitral valve, underscoring the importance of a pertinent dialogue between specialists and by using a more appropriate and unitary terminology.

Clinical significance of papillary muscle late enhancement detected via cardiac magnetic resonance imaging in patients with single old myocardial infarction

“…Papillary muscles (PMs) of the left ventricle (LV) are key components of the mitral valve apparatus, along with tendinous cords, anterior and posterior leaflets, annulus, and subvalvular apparatus [1]. PMs connect the LV wall with the mitral leaflets and annulus, and regulate the location of the mitral leaflets.…”

TexMi: Development of Tissue-Engineered Textile-Reinforced Mitral Valve Prosthesis

“…Whereas our results with ovine cells cannot be directly compared to those with human cells, they confirm the importance of the cell source in TEHVs. 28 Even more so, if we consider the cell-mediated tissue shrinkage, a major drawback of TEHVs and the main cause of valve failure. Whereas the TexMi produced with umbilical artery cells suffered marked tissue contraction, this did not happen with the TexMi from umbilical vein cells and the valve was perfectly functional after 21 days in vitro.…”

“…The mold was dimensioned and designed to reproduce the average annulus size and leaflet geometry according to literature data on human mitral valve anatomy. 27,28 It was designed with the 3D computer aided design (CAD) software Pro/Engineer (Wildfire 5.0; Parametric Technology Cooperation) and produced by rapid prototyping technology (Eden 350v; Object). It consists of two outer shells and an inner cylinder on which the thermostabilized mesh is placed together with two silicone connectors ( Fig.…”

Cellular Mechanisms in Mitral Valve Disease

“…From this annulus, two leaflets arise; anterior and posterior. The valve apparatus also involves complex connections between valve leaflets with the papillary muscles and the rest of the left ventricle through fibrous tendon-like structures called chordae tendinae [4][5][6]. These connections with the left ventricular wall are crucial to the optimum function of the valve [7].…”