TY - JOUR
T1 - Mitral leaflet anatomy revisited
AU - Quill, Jason L.
AU - Hill, Alexander J.
AU - Laske, Timothy G.
AU - Alfieri, Ottavio
AU - Iaizzo, Paul A.
N1 - Funding Information:
This work was supported in part by the Institute for Engineering in Medicine at the University of Minnesota and by Medtronic, Inc.
PY - 2009/5
Y1 - 2009/5
N2 - Objective: The aims of this work were to employ functional imaging capabilities of the Visible Heart laboratory and endoscopic visualization of mitral valves in perfusion-fixed specimens to better characterize variability in mitral valve leaflet anatomy and to provide a method to classify mitral leaflets that varies from the current nomenclature. Methods: We gathered functional endoscopic video footage (11 isolated reanimated human hearts) and static endoscopic anatomical images (38 perfusion-fixed specimens) of mitral leaflets. Commissure and cleft locations were charted using Carpentier's accepted description. Results: All hearts had 2 commissures separating anterior and posterior leaflets. "Standard" clefts separating P1/P2 were found in 66% of hearts (n = 25), and standard clefts separating P2/P3 were present in 71% of hearts (n = 27). "Deviant" clefts occurred in each region of the anterior leaflet (A1, A2, A3), and their relative occurrences were 5%, 8%, and 13% (n = 2, 3, 5), respectively. Deviant clefts were found in posterior leaflets: 13.2% in P1 (n = 5), 32% in P2 (n = 12), and 21% in P3 (n = 8). Conclusions: Humans elicit complex and highly variable mitral valve anatomy. We suggest a complementary, yet simple nomenclature to address variation in mitral valve anatomy by describing clefts as either standard or deviant and locating regions in which they occur (A1 to A3 or P1 to P3).
AB - Objective: The aims of this work were to employ functional imaging capabilities of the Visible Heart laboratory and endoscopic visualization of mitral valves in perfusion-fixed specimens to better characterize variability in mitral valve leaflet anatomy and to provide a method to classify mitral leaflets that varies from the current nomenclature. Methods: We gathered functional endoscopic video footage (11 isolated reanimated human hearts) and static endoscopic anatomical images (38 perfusion-fixed specimens) of mitral leaflets. Commissure and cleft locations were charted using Carpentier's accepted description. Results: All hearts had 2 commissures separating anterior and posterior leaflets. "Standard" clefts separating P1/P2 were found in 66% of hearts (n = 25), and standard clefts separating P2/P3 were present in 71% of hearts (n = 27). "Deviant" clefts occurred in each region of the anterior leaflet (A1, A2, A3), and their relative occurrences were 5%, 8%, and 13% (n = 2, 3, 5), respectively. Deviant clefts were found in posterior leaflets: 13.2% in P1 (n = 5), 32% in P2 (n = 12), and 21% in P3 (n = 8). Conclusions: Humans elicit complex and highly variable mitral valve anatomy. We suggest a complementary, yet simple nomenclature to address variation in mitral valve anatomy by describing clefts as either standard or deviant and locating regions in which they occur (A1 to A3 or P1 to P3).
UR - http://www.scopus.com/inward/record.url?scp=64649084943&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=64649084943&partnerID=8YFLogxK
U2 - 10.1016/j.jtcvs.2008.10.008
DO - 10.1016/j.jtcvs.2008.10.008
M3 - Article
C2 - 19379970
AN - SCOPUS:64649084943
SN - 0022-5223
VL - 137
SP - 1077
EP - 1081
JO - Journal of Thoracic and Cardiovascular Surgery
JF - Journal of Thoracic and Cardiovascular Surgery
IS - 5
ER -