Morphometric study of the human mitral annulus: guide for mitral valve surgery

Area of Science:

• Cardiac Surgery
• Anatomical Studies
• Medical Device Technology

Background:

• Mitral valve surgery necessitates a thorough understanding of mitral annulus anatomy to mitigate surgical risks.
• Accurate morphometric data of the mitral annulus is essential for successful ring annuloplasty or valve replacement procedures.

Purpose of the Study:

• To conduct a detailed morphometric analysis of the mitral annulus.
• To provide anatomical insights that aid in secure suturing during mitral valve interventions.

Main Methods:

• Anatomical investigation of 7 human hearts.
• Division of the mitral annulus into 8 distinct points for detailed analysis.
• Assessment of the annulus's relationship with mitral leaflets and aortic annulus.

Main Results:

• Identification of an annular fibrous segment consistently facing the left ventricular cavity (1.0–3.4 mm length).
• Significant inter- and intra-subject variability in mitral annulus dimensions.
• Shortest distance from the mitral annulus to the left circumflex coronary artery measured at the anterolateral commissure (3.3 mm).

Conclusions:

• Enhanced understanding of mitral annulus anatomy can help prevent operative complications during cardiac surgery.
• The study offers practical recommendations for suture placement in mitral valve replacement and ring annuloplasty.