Muscularization of the chordae tendinea of the mitral anterior papillary muscle.
Chorda tendinea
Chordae tendineae
Mitral valve
Papillary muscle
Journal
Surgical and radiologic anatomy : SRA
ISSN: 1279-8517
Titre abrégé: Surg Radiol Anat
Pays: Germany
ID NLM: 8608029
Informations de publication
Date de publication:
27 Aug 2024
27 Aug 2024
Historique:
received:
29
02
2024
accepted:
11
08
2024
medline:
27
8
2024
pubmed:
27
8
2024
entrez:
27
8
2024
Statut:
aheadofprint
Résumé
The chordae tendineae, described as fibro-collagenous structures, support the leaflets of the atrioventricular valves of the heart in various ways. The chordae tendineae are composed of collagen and elastic fibers. They connect to the ventricular side of the valve leaflets' free border and hinder the leaflets from swinging back into the atrial cavity during systole. Mitral valve chordae tendineae have been classified using a variety of classification systems. To our knowledge, we report a variant chordae tendinea that has yet to be described in the literature. The variant, present only on the mitral anterior papillary muscle, did not show the characteristic appearance of the chorda tendineae. Muscular fibers were observed extending from a larger than usual mitral anterior papillary muscle, inserting into the rough zone of the anterior leaflet. Several tendinous primary and secondary true leaflet chordae emerge from the apical portion of the anterior papillary muscle, inserting into the anterior leaflet's free edge and rough zone. Contraction of this muscular chorda during systole could disrupt the mechanics of valvular closure and result in possible regurgitation across the mitral valve. Additionally, this structure may be subject to rupture during myocardial infarction, leading to valvular dysfunction. The developmental connection between the chordae and papillary muscles could explain the anomalous muscularization of the chordae tendineae observed in this case.
Identifiants
pubmed: 39190035
doi: 10.1007/s00276-024-03465-z
pii: 10.1007/s00276-024-03465-z
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.
Références
Ambiga R, Verma S, Amala R (2014) Morphology of papillary muscles in the ventricles of heart - a review and meta-analysis. Morphologie Sep 107(358):100591. https://doi.org/10.1016/j.morpho.2023.01.002
doi: 10.1016/j.morpho.2023.01.002
Dal-Bianco JP, Levine RA (2013) Anatomy of the mitral valve apparatus: role of 2D and 3D echocardiography. Cardiol Clin 31:151–164. https://doi.org/10.1016/j.ccl.2013.03.001
doi: 10.1016/j.ccl.2013.03.001
pubmed: 23743068
Dearani JA, Mora BN, Nelson TJ, Haile DT, O’Leary PW (2015) Ebstein anomaly review: what’s now, what’s next? Expert Rev Cardiovasc Ther Oct 13(10):1101–1109. https://doi.org/10.1586/14779072.2015.1087849
doi: 10.1586/14779072.2015.1087849
Gunnal SA, Wabale RN, Farooqui MS (2013) Morphological variations of papillary muscles in the mitral valve complex in human cadaveric hearts. Singap Med J 54:44–48. https://doi.org/10.11622/smedj.2013011
doi: 10.11622/smedj.2013011
Gunnal SA, Wabale RN, Farooqui MS (2015) Morphological study of Chordae Tendinea in human cadaveric hearts. Heart Views 16:1–12. https://doi.org/10.4103/1995-705X.152994
doi: 10.4103/1995-705X.152994
pubmed: 25838872
pmcid: 4379635
Hinton RB, Yutzey KE (2011) Heart Valve structure and function in Development and Disease. Annu Rev Physiol 73:29–46. https://doi.org/10.1146/annurev-physiol-012110-142145
doi: 10.1146/annurev-physiol-012110-142145
pubmed: 20809794
pmcid: 4209403
Iwanaga J, Singh V, Takeda S, Ogeng’o J, Kim HJ, Moryś J, Ravi KS, Ribatti D, Trainor PA, Sañudo JR, Apaydin N, Sharma A, Smith HF, Walocha JA, Hegazy AMS, Duparc F, Paulsen F, Del Sol M, Adds P, Louryan S, Fazan VPS, Boddeti RK, Tubbs RS (2022) Standardized statement for the ethical use of human cadaveric tissues in anatomy research papers: recommendations from Anatomical Journal editors-in-Chief. Clin Anat 35(4):526–528. https://doi.org/10.1002/ca.23849
doi: 10.1002/ca.23849
pubmed: 35218594
Klues HG, Roberts WC, Maron BJ (1991) Anomalous insertion of papillary muscle directly into anterior mitral leaflet in hypertrophic cardiomyopathy. Significance in producing left ventricular outflow obstruction. Circulation 84:1188–1197. https://doi.org/10.1161/01.CIR.84.3.11884
doi: 10.1161/01.CIR.84.3.11884
pubmed: 1884449
Millington-Sanders C, Meir A, Lawrence L, Stolinski C (1998) Structure of Chordae Tendineae in the left ventricle of the human heart. J Anat 192:573–581. https://doi.org/10.1046/j.1469-7580.1998.19240573.x
doi: 10.1046/j.1469-7580.1998.19240573.x
pubmed: 9723984
pmcid: 1467811
Nielsen SL, Nygaard H, Fontaine AA, Hasenkam JM, He S, Andersen NT, Yoganathan AP (1999) Chordal force distribution determines systolic mitral leaflet configuration and severity of functional mitral regurgitation. J Am Coll Cardiol 33(3):843–853. https://doi.org/10.1016/S0735-1097(98)00627-5
doi: 10.1016/S0735-1097(98)00627-5
pubmed: 10080490
Nordrum IS, Skallerud B (2012) Smooth muscle in the human mitral valve: extent and implications for dynamic modeling. APMIS 120:484–494. https://doi.org/10.1111/j.1600-0463.2011.02860.x
doi: 10.1111/j.1600-0463.2011.02860.x
pubmed: 22583361
Oosthoek PW, Wenink AC, Wisse LJ, Gittenberger AC (1997) Development of the papillary muscles of the mitral valve: morphogenetic background of parachute-like asymmetric mitral valves and other mitral valve anomalies. J Thorac Cardiovasc Surg 116:36–46. https://doi.org/10.1016/S0022-5223(98)70240-5
doi: 10.1016/S0022-5223(98)70240-5
Perloff JK, Roberts WC (1972) The mitral apparatus: functional anatomy of mitral regurgitation. Circulation 46:227–239. https://doi.org/10.1161/01.cir.46.2.227
doi: 10.1161/01.cir.46.2.227
pubmed: 5046018
Pravin MS, Kramer DH, Raymond G (1970) Influence of the timing of atrial systole on mitral valve closure and on the first heart sound in man. Am JCardiol 26:231–237. https://doi.org/10.1016/0002-9149(70)90788-5
doi: 10.1016/0002-9149(70)90788-5
Ritchie J, Warnock JN, Yoganathan AP (2005) Structural characterization of the chordae tendineae in native porcine mitral valves. Ann Thorac Surg 80(1):189–197. https://doi.org/10.1016/j.athoracsur.2005.02.011
doi: 10.1016/j.athoracsur.2005.02.011
pubmed: 15975365
Silbiger JJ, Bazaz R (2009) Contemporary insights into the functional anatomy of the mitral valve. Am Heart J 158:887–895. https://doi.org/10.1016/j.ahj.2009.10.014
doi: 10.1016/j.ahj.2009.10.014
pubmed: 19958853
Silverman ME, Hurst JW (1968) The mitral complex. Interaction of the anatomy, physiology, and pathology of the mitral annulus, mitral valve leaflets, chordae tendineae, and papillary muscles. Am Heart J 76:399–418. https://doi.org/10.1016/0002-8703(68)90237-8
doi: 10.1016/0002-8703(68)90237-8
pubmed: 4952735
Standring et al (2020) Gray’s anatomy: the anatomical basis of clinical practice. Elsevier, Philadelphia, p 1084