Muresian Horia
University Hospital of Bucharest-Cardiovascular Surgery, Splaiul Independentei 169, Bucharest, Romania.
Clin Anat. 2009 Jan;22(1):85-98. doi: 10.1002/ca.20692.
As a result of the numerous clinical and surgical data accumulated so far, the classical image of the mitral valve-a bicuspid valve, with two leaflets and two papillary muscles-undergoes significant modifications. The valve, included into the larger concept of the mitral valvular complex unveils numerous important valences and characteristics, among which, some represent newer concepts, of clinical and surgical significance: the valvular complex is a subtle and finely-tuned system of elements acting in a coordinated manner; the mitral valve is an active valve and not a mere passive flap bordering the atrioventricular junction. Not least, the mitral valve contributes to the make up and function of the left ventricular outflow tract. The anatomical and functional interdependence between the mitral valve and the left ventricular myocardium is evident not only following their particularities of vascularization but also it is reflected in morbid states such as ischemic cardiac disease and dilated cardiomyopathy. All the new concepts and ideas, ask for a more profound study of the clinical anatomy of the mitral valve, underscoring the importance of a pertinent dialogue between specialists and by using a more appropriate and unitary terminology.
由于迄今为止积累的大量临床和手术数据,二尖瓣的经典形象——一个双叶双乳头肌的双尖瓣——正在经历重大改变。包含在二尖瓣复合体这一更大概念中的瓣膜展现出许多重要的价值和特征,其中一些代表了具有临床和手术意义的新概念:瓣膜复合体是一个由各部分以协调方式作用的微妙且精细调节的系统;二尖瓣是一个主动瓣膜,而不仅仅是毗邻房室交界的被动瓣叶。同样重要的是,二尖瓣对左心室流出道的构成和功能也有贡献。二尖瓣与左心室心肌之间的解剖和功能相互依存关系不仅体现在它们血管化的特殊性上,也反映在诸如缺血性心脏病和扩张型心肌病等病态中。所有这些新概念和观点都要求对二尖瓣的临床解剖进行更深入的研究,强调专家之间进行恰当对话的重要性,并使用更合适和统一的术语。