Athavale Sunita, Deopujari Rashmi, Sinha Urmila, Lalwani Rekha, Kotgirwar Sheetal
Department of Anatomy, All India Institute of Medical Sciences, Bhopal, India.
Department of Anatomy, People's College of Medical Sciences and Research Center, Bhopal, India.
Anat Cell Biol. 2017 Mar;50(1):1-6. doi: 10.5115/acb.2017.50.1.1. Epub 2017 Mar 29.
Advancement in imaging techniques and interventional cardiology procedures have generated renewed interest in anatomy of tricuspid valve complex. The purpose of the present study was to characterize the morphology of tricuspid valve leaflets using objective criteria. Thirty-six embalmed cadaveric hearts were utilized for the present study. Leaflet morphology was studied using newly defined criteria. Commissural zones were identified and leaflets were delineated. Presence of scallops was also recorded. Single leaflet was observed in six cases, double in 26 cases, and triple in four cases. The anterior leaflet is large with multiple scallops and frequently accrues portion of inferior leaflet. The septal leaflet is in the form of a plateau and also frequently accrues parts of inferior leaflet. The inferior leaflet rarely occurs as independent leaflet. A wide un-indented basal zone exists across the valve leaflets. The study found that the tricuspid valve is rarely tricuspid. It also generated the hypotheses that the tricuspid valve does not open completely due to presence of a wide basal zone and the valve does not close completely owing to incongruence and lack of coaptation of leaflets. The findings provide clear understanding of leaflet morphology of tricuspid valve. This will help imaging specialists for interpretation of images and cardiologists for interventional procedures. The findings also enhance our understanding of pathophysiology of conditions like functional tricuspid regurgitation.
成像技术和介入心脏病学程序的进展重新引发了人们对三尖瓣复合体解剖结构的兴趣。本研究的目的是使用客观标准来描述三尖瓣小叶的形态。本研究使用了36个防腐处理的尸体心脏。使用新定义的标准研究小叶形态。确定连合区并描绘小叶。还记录了扇贝的存在情况。观察到单叶6例，双叶26例，三叶4例。前叶大，有多个扇贝，且常合并下叶的一部分。隔叶呈平台状，也常合并下叶的部分。下叶很少作为独立叶出现。瓣膜小叶上存在一个宽阔的无凹陷基底部区域。研究发现三尖瓣很少是真正的三叶。研究还提出了以下假设：由于存在宽阔的基底部区域，三尖瓣不能完全打开；由于小叶不协调和缺乏贴合，瓣膜不能完全关闭。这些发现为三尖瓣小叶形态提供了清晰的认识。这将有助于影像专家解读图像，也有助于心脏病专家进行介入手术。这些发现还增强了我们对功能性三尖瓣反流等病症病理生理学的理解。
