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An Image Guided Transapical Mitral Valve Leaflet Puncture Model of Controlled Volume Overload from Mitral Regurgitation in the Rat
Published on: May 19, 2020
Mitral leaflet anatomy revisited.
Jason L Quill1, Alexander J Hill, Timothy G Laske
1Department of Surgery, University of Minnesota, Minneapolis, Minn. 55455, USA.
The Journal of Thoracic and Cardiovascular Surgery
|April 22, 2009
Summary
Human mitral valve anatomy is highly variable, with many leaflets showing non-standard clefts. This study proposes a new classification system for mitral valve leaflets based on standard or deviant clefts.
Area of Science:
- Cardiovascular Anatomy
- Surgical Anatomy
- Medical Imaging
Background:
- The mitral valve's complex anatomy presents challenges in classification.
- Existing nomenclature may not fully capture the variability in mitral valve leaflet structure.
Purpose of the Study:
- To characterize the anatomical variability of mitral valve leaflets using functional imaging and endoscopic visualization.
- To develop a novel classification system for mitral valve leaflets accounting for anatomical variations.
Main Methods:
- Utilized functional endoscopic video footage from 11 reanimated human hearts.
- Analyzed static endoscopic anatomical images from 38 perfusion-fixed specimens.
- Mapped commissure and cleft locations according to Carpentier's description.
Main Results:
- All specimens exhibited 2 commissures separating anterior and posterior leaflets.
- Standard clefts were observed in 66% (P1/P2) and 71% (P2/P3) of hearts.
- Deviant clefts were identified in anterior leaflets (5-13%) and posterior leaflets (13-32%).
Conclusions:
- Human mitral valve anatomy is notably complex and variable.
- A simple, complementary nomenclature is proposed, classifying clefts as standard or deviant within specific leaflet regions (A1-A3, P1-P3).
- This new classification aims to better describe mitral valve leaflet variations.
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