DOI: 10.5176/2382-6096_CMMA14.17
Authors: Sivananthini Udhayakumar, S. G. Yasawardene
Abstract: A fundamental knowledge of cardiac anatomy forms the cornerstone of clinical cardiology and many publications have appeared dealing with its detailed anatomy in Caucasians and in some other racial groups. We present data of morphology and dimensions of the mitral valve and its relationship with demographic data in a Sri Lankan population. This will be helpful for the anatomists, surgeons and radiologists. Three hundred and twenty (320) fresh adult hearts obtained from natives of Sri Lanka who had died of noncardiovascular causes were studied to determine the basic variations of the morphology and morphometry of mitral valvular apparatus.The findings were compared with previous studies in other racial groups. Mitral annular circumference (MAC) ranged from 58–110 mm with a mean of 93.24 mm ± 7.3SD. The mean size of the MAC was 94.41 mm ±5.9 SD in males and 84.62 mm ± 8 SD in females and the difference was statistically significant (p<0.001). Our results of circumference are comparable with those reported from India and are lower than that of Caucasians. A significant positive relationship exists between the mitral annular circumference with age, height an body surface area of the person (p<0.05). The contribution of posterior mitral valve leaflet to the annulus was larger (52{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) than that of anterior leaflet (34{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) and commissural zones (14{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}). The anterior leaflet is longer in length (20.24 mm ± 2.1SD) than that of the posterior leaflet (13.25 mm ± 2.2SD), and was semicircular (55{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) or triangular (4 {6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}). In 5{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465} of the hearts, notches were seen in its free border of anterior leaflet supported by cleft chordae. The posterior leaflet was not consistently triple scalloped, but had one, two, four or five scallops in 110 (34{6e6090cdd558c53a8bc18225ef4499fead9160abd3419ad4f137e902b483c465}) hearts. This study highlights the measurements of valve parameters being smaller in Sri Lankans than reported for the Caucasians, with minor morphological variations. Compared with Caucasians, the commissures occupied smaller areas of the annulus, and may facilitate the rapid fusion of valve tissue in rheumatic valvulitis. These would be of significance in echocardiographic analysis and surgical management of valvular disease in Sri Lankans.
Keywords: Mitral valve, Annular circumference, Fresh autopsy, Leaflet, Sri Lankan
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