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Chapter 4 - Surgical Anatomy of the Valves of the Heart

Published online by Cambridge University Press:  10 April 2024

Robert H. Anderson
Affiliation:
Institute of Genetic Medicine, Newcastle University
Andrew C. Cook
Affiliation:
University College London
Diane E. Spicer
Affiliation:
University of Florida
Anthony M. Hlavacek
Affiliation:
Medical University of South Carolina
Carl L. Backer
Affiliation:
Cincinnati Children's Hospital
Justin T. Tretter
Affiliation:
Cleveland Clinic, Ohio
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Summary

It is axiomatic that a thorough knowledge of valvar anatomy is a prerequisite for successful surgery, be it valvar replacement or reconstruction. The surgeon will also require a firm understanding of the arrangement of other aspects of cardiac anatomy to ensure safe access to a diseased valve or valves. These features were described in the previous chapter. Knowledge of the surgical anatomy of the valves themselves, however, must be founded on appreciation of their component parts, the relationships of the individual valves to each other, and their relationships to the chambers and arterial trunks within which they reside. This requires understanding of, first, the basic orientation of the cardiac valves, emphasizing the intrinsic features that make each valve distinct from the others. Such information must then be supplemented by attention to their relationships with other structures that the surgeon must avoid, notably the conduction tissues and the major channels of the coronary circulation.

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Publisher: Cambridge University Press
Print publication year: 2024

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References

References Cited

Perloff, JK, Roberts, WC. The mitral apparatus. Functional anatomy of mitral regurgitation. Circulation 1972; 46: 227239.CrossRefGoogle ScholarPubMed
Frater, RWM, Anderson, RH. How can we logically describe the components of the arterial valves? J Heart Valve Dis 2010; 19: 438440.Google ScholarPubMed
Sievers, HH, Hemmer, G, Beyersdorf, F, et al. The everyday used nomenclature of the aortic root components: the Tower of Babel? Eur J Cardiothoracic Surg 2012; 41: 478482.CrossRefGoogle ScholarPubMed
Anderson, RH, Spicer, DE, Quintessenza, JA, Najm, HK, Tretter, JT. Words and how we use them – which is to be the master? J Card Surg 2022; 37: 24812485.CrossRefGoogle ScholarPubMed
Anderson, RH. Demolishing the Tower of Babel. Eur J Cardiothorac Surg 2012; 41: 483484.CrossRefGoogle ScholarPubMed
Anderson, RH, Garbi, M, Zugwitz, D, et al. Anatomy of the mitral valve relative to controversies concerning the so-called annular disjunction. Heart 2023; 109: 734739.CrossRefGoogle ScholarPubMed
Sutton, JPIII, Ho, SY, Anderson, RH. The forgotten interleaflet triangles: A review of the surgical anatomy of the aortic valve. Ann Thor Surg 1995; 59: 419427.CrossRefGoogle ScholarPubMed
Garbi, M, Garweg, C. Arrhythmia in mitral valve prolapse: all roads lead to Rome. J Am Coll Cardiol 2020; 76: 650652.CrossRefGoogle ScholarPubMed
Angelini, A, Ho, SY, Anderson, RH, Davies, MJ, Becker, AE. A histological study of the atrioventricular junction in hearts with normal and prolapsed leaflets of the mitral valve. Br Heart J 1988; 59: 712716.CrossRefGoogle ScholarPubMed
McAlpine, WA. Heart and Coronary Arteries: An Anatomical Atlas for Clinical Diagnosis, Radiological Investigation, and Surgical Treatment. New York: Springer-Verlag; 1975: Chapter 2.CrossRefGoogle Scholar
Toh, H, Mori, S, Izawa, Y, et al. Prevalence and extent of mitral annular disjunction in structurally normal hearts: comprehensive three-dimensional analysis using cardiac computed tomography. Eur Heart J Cardiovasc Imag 2021; 22: 614622.CrossRefGoogle Scholar
Zugwitz, D, Fung, K, Aung, N, et al. Mitral annular disjunction assessed by cardiovascular magnetic resonance imaging: insights from UK Biobank Population Study. J Am Coll Cardiol Card Img 2022; 15: 18561866.CrossRefGoogle ScholarPubMed
Victor, S, Nayak, VM. The tricuspid valve is bicuspid. J Heart Valve Dis 1994; 3: 2736.Google ScholarPubMed
Hołda, MK, Zhingre Sanchez, JD, Bateman, MG, Iaizzo, PA. Right atrioventricular valve leaflet morphology redefined: implications for transcatheter repair procedures. JACC Cardiovasc Interv 2019; 12: 169178.CrossRefGoogle ScholarPubMed
Sutton, JP 111, Sy, Ho, Vogel, M, Anderson, RH. Is the morphologically right atrioventricular valve tricuspid? J Heart Valve Dis 1995; 4: 571575.Google ScholarPubMed
Tretter, JT, Sarwark, AS, Anderson, RH, Spicer, DE. Assessment of the anatomical variation to be found in the normal tricuspid valve. Clin Anat 2016; 29: 399407CrossRefGoogle ScholarPubMed
Yacoub, M. Anatomy of the mitral valve chordae and cusps. In Kalmason, D, ed., The Mitral Valve. A Pluridisciplinary Approach. London: Edward Arnold; 1976: pp. 1520.Google Scholar
Kumar, N, Kumar, M, Duran, CM. A revised terminology for recording surgical findings of the mitral valve. J Heart Valve Dis 1995; 4: 7677.Google ScholarPubMed
Frater, R. Anatomy and physiology of the normal mitral valve. (Discussion) In Kalmanson, D, ed., The Mitral Valve. London: Edward Arnold; 1976: p. 41.Google Scholar
Lam, JHC, Ranganathan, N, Wigle, ED, Silver, MD. Morphology of the human mitral valve. I. Chordae tendineae: a new classification. Circulation 1970; 41: 449458.CrossRefGoogle ScholarPubMed
Becker, AE, de Wit, APM. Mitral valve apparatus. A spectrum of normality relevant to mitral valve prolapse. Br Heart J 1979; 42: 680689.CrossRefGoogle ScholarPubMed
Van der Bel-Kahn, J, Duren, DR, Becker, AE. Isolated mitral valve prolapse: chordal architecture as an anatomic basis in older patients. J Am Coll Cardiol 1985; 5: 13351340.CrossRefGoogle ScholarPubMed
Roberts, WC. The 2 most common congenital heart diseases. (Editorial) Am J Cardiol 1984; 53: 1198.CrossRefGoogle ScholarPubMed
Carpentier, A, Branchini, B, Cour, JC, et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg 1976; 72: 854866.CrossRefGoogle ScholarPubMed
Victor, S, Nayak, VM. Definition and function of commissures, slits and scallops of the mitral valve: analysis in 100 hearts. AustralAs J Cardiac Thorac Surg 1994; 3: 816.Google Scholar
Amofa, D, Mori, S, Toh, H, et al. The rotational position of the aortic root related to its underlying ventricular support. Clin Anat 2019; 32: 11071117.CrossRefGoogle ScholarPubMed
Rosenquist, GC, Clark, EB, Sweeny, LJ, McAllister, HA. The normal spectrum of mitral and aortic valve discontinuity. Circulation 1976; 54: 298301.CrossRefGoogle ScholarPubMed
Dodge-Khatami, A, Mavroudis, C, Backer, CL. Congenital heart surgery nomenclature and database project: anomalies of the coronary arteries. Ann Thorac Surg 2000; 69: S270279.CrossRefGoogle ScholarPubMed
Merrick, AF, Yacoub, MH, Ho, SY, Anderson, RH. Anatomy of the muscular subpulmonary infundibulum with regard to the Ross procedure. Ann Thorac Surg 2000; 69: 556561.CrossRefGoogle ScholarPubMed
McFadden, PM, Culpepper, WS III, Ochsner, JL. Iatrogenic right ventricular failure in tetralogy of Fallot repairs: reappraisal of a distressing problem. Ann Thorac Surg 1982; 33: 400402.CrossRefGoogle ScholarPubMed

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