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Quadricuspid pulmonary valve: macroscopic and microscopic morphometric examination

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Abstract

A quadricuspid pulmonary valve obtained upon autopsy of a 26-year-old male was examined. The macroscopic evaluation revealed three normal (posterior, right anterior and left anterior) leaflets and one additional leaflet of the pulmonary valve. Except that, the heart showed neither other anatomical variabilities nor any signs of heart disease. The additional leaflet was located between the left anterior and right anterior leaflets and was significantly smaller in size. Under the microscope, all leaflets showed preservation of the typical, layered structure. The thickness and extracellular matrix composition of the particular layers differed between the leaflets. Right ventricular myocardium (myocardial sleeves) exceeded the level of the hinge line in all three normal leaflets, which was not observed in the additional leaflet. Autonomic nerves and ganglia were not seen in the perivalvular epicardial adipose tissue surrounding the additional leaflet. The sinus wall of all the leaflets revealed typical organization of collagen bundles as well as elastic fibers and showed no signs of disruption. The abnormality seen in the structure of the pulmonary valve is likely to be a result of disturbed embryonic development and may affect the clinical management of patients with such variation.

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Funding

This work was supported by a statutory Grant (K/ZDS/007919 to GJL) from the Jagiellonian University Medical College.

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Authors and Affiliations

  1. Department of Histology, Jagiellonian University Medical College, Kraków, Poland

    Bernard Solewski, Maciej Lis, Jan Chrzanowski, Małgorzata Jasińska & Grzegorz J. Lis

  2. Department of Anatomy, Jagiellonian University Medical College, Kopernika 12, 31-034, Kraków, Poland

    Bernard Solewski, Maciej Lis & Mateusz K. Hołda

  3. Edinburgh Medical School, University of Edinburgh, Edinburgh, UK

    Joanna Wolska

  4. Department of Forensic Medicine, Jagiellonian University Medical College, Kraków, Poland

    Filip Bolechała

Authors
  1. Bernard Solewski
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  2. Maciej Lis
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  3. Jan Chrzanowski
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  4. Joanna Wolska
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  5. Małgorzata Jasińska
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  6. Filip Bolechała
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  7. Mateusz K. Hołda
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  8. Grzegorz J. Lis
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Contributions

BS: project development, data collection, data analysis, manuscript writing. ML: project development, data collection, data analysis, manuscript editing. JC: data collection, data analysis. JW: manuscript editing. MJ: data analysis. FB: data collection. MKH: project development, manuscript editing. GJL: project development, data management, data analysis, manuscript writing

Corresponding author

Correspondence to Bernard Solewski.

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The authors declare that they have no conflict of interest.

Ethical approval

This study was approved by the Bioethical Committee of the Jagiellonian University in Kraków, Poland.

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Solewski, B., Lis, M., Chrzanowski, J. et al. Quadricuspid pulmonary valve: macroscopic and microscopic morphometric examination. Surg Radiol Anat 42, 385–389 (2020). https://doi.org/10.1007/s00276-019-02387-5

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  • DOI: https://doi.org/10.1007/s00276-019-02387-5

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