Hołda Jakub, Słodowska Katarzyna, Malinowska Karolina, Strona Marcin, Mazur Małgorzata, Jasińska Katarzyna A, Matuszyk Aleksandra, Koziej Mateusz, Walocha Jerzy A, Hołda Mateusz K
HEART-Heart Embryology and Anatomy Research Team, Department of Anatomy, Jagiellonian University Medical College, 31-007 Cracow, Poland.
Department of Forensic Medicine, Jagiellonian University Medical College, 31-007 Cracow, Poland.
Diagnostics (Basel). 2021 May 26;11(6):960. doi: 10.3390/diagnostics11060960.
The right atrioventricular valve (RAV) is an important anatomical structure that prevents blood backflow from the right ventricle to the right atrium. The complex anatomy of the RAV has lowered the success rate of surgical and transcatheter procedures performed within the area. The aim of this study was to describe the morphology of the RAV and determine its spatial position in relation to selected structures of the right atrium. We examined 200 randomly selected human adult hearts. All leaflets and commissures were identified and measured. The position of the RAV was defined. Notably, 3-leaflet configurations were present in 67.0% of cases, whereas 4-leaflet configurations were present in 33.0%. Septal and mural leaflets were both significantly shorter and higher in 4-leaflet than in 3-leaflet RAVs. Significant domination of the muro-septal commissure in 3-leflet valves was noted. The supero-septal commissure was the most stable point within RAV circumference. In 3-leaflet valves, the muro-septal commissure was placed within the cavo-tricuspid isthmus area in 52.2% of cases, followed by the right atrial appendage vestibule region (20.9%). In 4-leaflet RAVs, the infero-septal commissure was located predominantly in the cavo-tricuspid isthmus area and infero-mural commissure was always located within the right atrial appendage vestibule region. The RAV is a highly variable structure. The supero-septal part of the RAV is the least variable component, whereas the infero-mural is the most variable. The number of detected RAV leaflets significantly influences the relative position of individual valve components in relation to right atrial structures.
右房室瓣（RAV）是一个重要的解剖结构，可防止血液从右心室回流至右心房。RAV复杂的解剖结构降低了该区域手术和经导管操作的成功率。本研究的目的是描述RAV的形态，并确定其相对于右心房选定结构的空间位置。我们检查了200例随机选取的成年人心脏。识别并测量了所有瓣叶和瓣叶联合。确定了RAV的位置。值得注意的是，67.0%的病例存在三叶瓣结构，而33.0%存在四叶瓣结构。与三叶瓣RAV相比，四叶瓣RAV的间隔瓣叶和壁瓣叶在长度和高度上均显著更短和更高。注意到三叶瓣瓣膜中壁-间隔瓣叶联合占显著优势。上-间隔瓣叶联合是RAV圆周内最稳定的点。在三叶瓣瓣膜中，52.2%的病例壁-间隔瓣叶联合位于腔静脉-三尖瓣峡部区域，其次是右心耳前庭区域（20.9%）。在四叶瓣RAV中，下-间隔瓣叶联合主要位于腔静脉-三尖瓣峡部区域，而下-壁瓣叶联合总是位于右心耳前庭区域。RAV是一个高度可变的结构。RAV的上-间隔部分是最不易变的组成部分，而下-壁部分是最易变的。检测到的RAV瓣叶数量显著影响各个瓣膜组件相对于右心房结构的相对位置。
