Division of Anatomy, Center for Anatomy and Cell Biology, MIC and CMI, Medical University of Vienna, Vienna, Austria.
Department of Cardiovascular Surgery, University Heart Center Freiburg-Bad Krozingen, Freiburg, Germany.
Eur J Cardiothorac Surg. 2024 Jul 1;66(1). doi: 10.1093/ejcts/ezae240.
This study aimed to provide comprehensive morphological descriptions of the morphology of the tricuspid valve and to evaluate if a novel echocardiography-based tricuspid valve nomenclature can also be understood anatomically.
Tricuspid valves of 60 non-embalmed human body donors without a medical history of pathologies or macroscopic malformations of the heart were included. Length, height and surface area of leaflets were measured. The valves were morphologically classified according to a novel echocardiography-based classification, in which 6 types are distinguished: classic 3-leaflet configuration, bicuspid valves, valves with 1 leaflet split into 2 scallops or leaflets and valves with 2 leaflets divided into 2 scallops or leaflets.
We found a true 3-leaflet configuration in only 19 (31.7%) of valves. Five (8.3%) had a 2-leaflet configuration with a fused anterior and posterior leaflet. Of those, 3 had a divided septal leaflet. Four valves (6.7%) had a divided anterior leaflet, 17 (28.3%) had a divided posterior leaflet, 6 (10%) had a divided septal leaflet and 9 (15.0%) had 2 leaflets divided. Overall, 39 (65%) of valves have at least 1 leaflet that is divided. In 22 (36.7%) specimens, the leaflet was divided into true leaflets, and in 17 (28.3%) specimens, the leaflet was divided into scallops. In addition, we could identify 9 (15%) valves having 1 leaflet divided not only in 2 but 3 scallops or leaflets.
This study provides further anatomical insight for the significant variability in the morphology of the tricuspid valve. By updating the understanding of its morphological characteristics, this study equips clinicians with valuable insights to effectively advance surgical and interventional treatment of tricuspid valves.
本研究旨在提供三尖瓣形态的全面形态描述，并评估一种新的基于超声心动图的三尖瓣命名法是否也可以从解剖学上理解。
纳入 60 例非防腐人体供体的三尖瓣，这些供体无心脏病理学或大体畸形病史。测量瓣叶的长度、高度和表面积。根据一种新的基于超声心动图的分类方法对瓣膜进行形态分类，其中区分出 6 种类型：经典的三叶式构型、二叶瓣、瓣叶分为 2 个扇区或瓣叶和瓣叶分为 2 个扇区。
我们仅在 19 个（31.7%）瓣膜中发现真正的三叶式构型。5 个（8.3%）具有融合的前、后瓣的二叶瓣构型，其中 3 个具有分隔的隔瓣。4 个瓣膜（6.7%）具有分隔的前瓣，17 个（28.3%）具有分隔的后瓣，6 个（10%）具有分隔的隔瓣，9 个（15.0%）具有 2 个瓣叶分开。总的来说，39 个（65.0%）瓣膜至少有 1 个瓣叶分开。在 22 个（36.7%）标本中，瓣叶被分为真正的瓣叶，在 17 个（28.3%）标本中，瓣叶被分为扇区。此外，我们还可以识别出 9 个（15%）瓣膜的 1 个瓣叶不仅分为 2 个扇区，还分为 3 个扇区或瓣叶。
本研究为三尖瓣形态的显著变异性提供了进一步的解剖学见解。通过更新对其形态特征的认识，本研究为临床医生提供了有价值的见解，有助于有效推进三尖瓣的外科和介入治疗。
