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Aorto-mitral annular dynamics.

Tomasz A Timek1, G Randall Green, Frederick A Tibayan

  • 1Department of Cardiothoracic Surgery, Stanford, California 94305, USA.

The Annals of Thoracic Surgery
|December 12, 2003
PubMed
Summary
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Dynamic changes in aortic and mitral annulus areas occur reciprocally, not through fibrous continuity. Aorto-mitral flexion increases with contractility, potentially aiding heart function.

Area of Science:

  • Cardiovascular Physiology
  • Cardiac Mechanics
  • Valvular Dynamics

Background:

  • The aortic and mitral valves are linked by fibrous aorto-mitral continuity.
  • Their synchronized dynamic function remains incompletely understood.

Purpose of the Study:

  • To characterize the synchronous dynamic physiology of the aortic and mitral valves.
  • To investigate the role of aorto-mitral continuity in valvular dynamics.

Main Methods:

  • Seven sheep were implanted with radiopaque markers on the left ventricle, mitral annulus, and aortic annulus.
  • Bi-plane videofluoroscopy was used to record marker movement throughout the cardiac cycle.
  • Three-dimensional coordinates allowed calculation of annular areas, circumferences, and aorto-mitral angle (flexion).

Related Experiment Videos

Main Results:

  • Aortic and mitral annular areas changed reciprocally during diastole and early systole.
  • Aortic annular area changed by 32% and mitral annular area by 13%.
  • Aortic and mitral annulus flexion increased with inotropic stimulation, suggesting a role in left ventricle ejection.

Conclusions:

  • Dynamic annular area changes are not solely mediated by fibrous continuity.
  • Increased aorto-mitral flexion with enhanced contractility may improve left ventricle ejection.
  • The impact of valvular surgery on aorto-mitral flexion requires further study.