Skip to main content

Abstract

The mitral valve apparatus comprises the annulus and a portion of myocardium located above and below it, the leaflets, the chordae tendineae and the papillary muscles (Fig. 1.1). The mitral valve apparatus and the left ventricle are so interdependent that there is no mitral valve defect that does not affect the left ventricle in some way, and, in turn, there is no morphological or functional alteration of the left v entricle that has no consequence, to a greater or lesser extent, for the mitral valve. Therefore, the mitral valve is not a passive structure that moves solely as a result of the forces generated by cardiac activity, but rather a structure with its own sphinteric activity concentrated mainly in the annulus, which contributes to the ventricle’s contractility and, in turn, is heavily affected by it.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Van Gils FA (1981) The fibrous skeleton in the human heart: embryological and pathogenetic considerations. Virchows Arch A Pathol Anat Histol 393:61–73

    Article  PubMed  Google Scholar 

  2. Davila JC, Palmer TE (1962) The mitral valve: anatomy and pathology for the surgeon. Arch Surg 84:174–198

    Article  PubMed  CAS  Google Scholar 

  3. Silverman ME, Hurst JW (1968) The mitral complex: interaction of the anatomy, physiology, and pathology of the mitral annulus, mitral valve leaflets, chordae tendineae, and papillary muscles. Am Heart J 76:399–418

    Article  PubMed  CAS  Google Scholar 

  4. Tsakiris AG, Von Bernuth G, Rastelli GC et al (1971) Size and motion of the mitral alve annulus in anesthetized intact dogs. J Appl Physiol 30:611–618

    PubMed  CAS  Google Scholar 

  5. Perloff JK, Roberts WC (1972) The mitral apparatus: functional anatomy of mitral regurgitation. Circulation 46:227–239

    Article  PubMed  CAS  Google Scholar 

  6. Fenoglio J Jr, Tuan DP, Wit AL et al (1972) Canine mitral complex: ultrastructure and electromechanical properties. Circ Res 31:417–430

    Article  PubMed  Google Scholar 

  7. Walmsley R. Anatomy of human mitral valve in adult cadaver and comparative anatomy of the valve (1978) Br Heart J 40:351–366

    Article  PubMed  CAS  Google Scholar 

  8. Ormiston JA, Shah PM, Tei C et al (1981) Size and motion of the mitral valve annulus in man: I. A two-dimensional echocardiographic method and findings in normal subjects. Circulation 64:113–120

    Article  PubMed  CAS  Google Scholar 

  9. Toumanidis ST, Sideris DA, Papamichael CM et al (1992) The role of mitral annulus motion in left ventricular function. Acta Cardiol 47:331–348

    PubMed  CAS  Google Scholar 

  10. Anderson RH, Wilcox BR (1996) The anatomy of the mitral valve. In: Wells FC, Shapiro M (eds) Mitral valve disease. Butterworth-Heinemann, Oxford

    Google Scholar 

  11. Fenster MS, Feldman D (1995) Mitral regurgitation: an overview. Curr Probl Cardiol 20:193–230

    Article  PubMed  CAS  Google Scholar 

  12. Karlsson MO, Glasson JR, Bolger AF et al (1998) Mitral valve opening in the ovine heart. Am J Physiol Heart Circ Physiol 274:552–563

    Google Scholar 

  13. Levine RA, Triulzi MO, Harrigan P, Weyman AE (1987) The relationship of mitral annular shape to the diagnosis of mitral valve prolapse. Circulation 75:756–767

    Article  PubMed  CAS  Google Scholar 

  14. Sovak M, Lynch PR, Stewart GH (1973) Movement of the mitral valve and its correlation with the first heart sound: selective valvular visualization and high-speed cineradiography in intact dogs. Invest Radiol 8:150–155

    Article  PubMed  CAS  Google Scholar 

  15. Pohost GM, Dinsmore RE, Rubenstein JJ et al (1975) The echocardiogram of the anterior leaflet of the mitral valve: Correlation with hemodynamic and cineroentgenographic studies in dogs. Circulation 51:88–97

    Article  PubMed  CAS  Google Scholar 

  16. Tsakiris AG, Gordon DA, Mathieu Y et al (1975) Motion of both mitral valve leaflets: a cineroentgenographic study in intact dogs. J Appl Physiol 39:359–366

    PubMed  CAS  Google Scholar 

  17. Pollick C, Pittman M, Filly K et al (1982) Mitral and aortic valve orifice area in normal subjects and in patients with congesti vecardiomyopathy: determination by tw o-dimensional echocardiography. Am J Cardiol 49:1191–1196

    Article  PubMed  CAS  Google Scholar 

  18. Tsakiris AG, Sturm RE, Wood EH (1973) Experimental studies on the mechanisms of closure of cardiac valves with use of roentgen videodensitometry. Am J Cardiol 32:136–143

    Article  PubMed  CAS  Google Scholar 

  19. Davis PKB, Kinmonth JB (1963) The movements of the annulus of the mitral valve. J Cardiovasc Surg 4:427–431

    CAS  Google Scholar 

  20. Keren G, Sonnenblick EH, LeJemtel TH (1988) Mitral annulus motion: relation to pulmonary venous and transmitral flows in normal subjects and in patients with dilated cardiomyopathy. Circulation 78:621–629

    Article  PubMed  CAS  Google Scholar 

  21. Choure AJ, Garcia MJ, Hesse B et al (2006) In vi vo analysis of the anatomical relationship of coronary sinus to mitral annulus and left circumflex coronary artery using cardiac multi-detector computed tomography: implications for percutaneous coronary sinus mitral annuloplasty. J Am Coll Cardiol 48:1938–1945

    Article  PubMed  Google Scholar 

  22. Luther RR, Meyers SN (1974) Acute mitral insuf ficiency secondary to ruptured chordae tendineae. Arch Intern Med 134:568–578

    Article  PubMed  CAS  Google Scholar 

  23. Voci P, Bilotta F, Caretta Q et al (1995) Papillary muscle perfusion pattern: a hypothesis for ischemic papillary muscle dysfunction. Circulation 91:1714–1718

    Article  PubMed  CAS  Google Scholar 

  24. Armour JA, Randall WC (1978) Electrical and mechanical activity of papillary muscle. Am J Physiol 218:1710–1717

    Google Scholar 

  25. Cronin R, Armour JA, Randall WC (1969) Function of the in-situ papillary muscle in the canine left ventricle. Circ Res 25:67–75

    Article  PubMed  CAS  Google Scholar 

  26. Lam JHC, Ranganathan N, Wigle ED et al (1970) Morphology of the human mitral valve: I. Chordae tendineae: a new classification. Circulation 41:449–458

    Article  PubMed  CAS  Google Scholar 

  27. Marzilli M, Sabbah HN, Lee T et al (1980) Role of the papillary muscle in opening and closure of the mitral valve. Am J Physiol Heart Circ Physiol 238:348–354

    Google Scholar 

  28. Hokken RB, Bartelings MM, Bogers AJ, Gittenberger-DeGroot AC (1997) Morphology of the pulmonary and aortic roots with regard to the pulmonary autograft procedure. J Thorac Cardiovasc Surg 113:453–461

    Article  PubMed  CAS  Google Scholar 

  29. Cheng A, Dagum P, Miller DC (2007) Aortic root dynamics and surgery: from craft to science. Philos Trans R Soc Lond B Biol Sci 362:1407–1419

    Article  PubMed  Google Scholar 

  30. Silver MA, Roberts WC (1985) Detailed anatomy of the normally functioning aortic valve in hearts of normal and increased weight. Am J Cardiol 55:454–461

    Article  PubMed  CAS  Google Scholar 

  31. Misfeld M, Sievers H (2007) Heart valve macro- and microstructure. Philos Trans R Soc Lond B Biol Sci 362:1421–1436

    Article  PubMed  Google Scholar 

  32. Vollebergh FE, Becker AE (1977) Minor congenital variations of cusp size in tricuspid aortic valves. Possible link with isolated aortic stenosis. Br Heart J 39:1006–1011

    Article  PubMed  CAS  Google Scholar 

  33. Kunzelman KS, Grande KJ, David TE et al (1994) Aortic root and v alve relationships. Impact on surgical repair. J Thorac Cardiovasc Surg 107:162–170

    PubMed  CAS  Google Scholar 

  34. Anderson RH (2000) Clinical anatomy of the aortic root. Heart 84:670–673

    Article  PubMed  CAS  Google Scholar 

  35. Piazza N, De Jaegere P, Schultz et al (2008) Anatomy of the aortic valvar complex and its implications for transcatheter implantation of the aortic valve. Circulation Cardiovasc Interv 1:74–81

    Article  Google Scholar 

  36. Mihaljevic T, Sayeed MR, Stamou SC et al (2008) Pathophysiology of aortic valve disease. In: Cohn LH (ed) Cardiac surgery in the adult. McGraw-Hill, New York

    Google Scholar 

  37. Roberts WC (1970) The congenitally bicuspid aortic valve. A study of 85 autopsy cases. Am J Cardiol 26:72–83

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Italia

About this chapter

Cite this chapter

Tamburino, C., Ussia, G.P. (2012). Anatomy. In: Percutaneous Treatment of Left Side Cardiac Valves. Springer, Milano. https://doi.org/10.1007/978-88-470-2631-5_1

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2631-5_1

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2630-8

  • Online ISBN: 978-88-470-2631-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics