Mitral homograft replacement requires a good knowledge about anatomy of the papillary muscles. In 60 (38 male, 22 female) cardiac preparations of various age (16-44 ages), branch distribution of the chordae tendineae and level of their fixation to the ventricular surface of the right and left cusps of mitral valves have been studied. Papillary muscles and chordae tendineae were examined and their geometrical arrangement was determined. Three groups of the left ventricular papillary muscle were defined. In group I (43.3%, 52/120) the basal part and the apex of the muscle were undivided. In group II (30%, 36/120) there were two heads; in subgroup II/A (20%, 36/120) the base of the papillary muscle was undivided and in II/B (10%, 12/120) it was divided into two separate parts. In group III (26.7%, 32/120) the papillary muscle had three heads. It was also observed that 2 to 15 chordae tendineae can originate from the apex of papillary muscle and 9 to 60 chordae tendineae can ended into the corresponding half of the valve insertions. Thus these definitions and morphologic types may be of great value during endoscopic and conventional mitral valve replacement or reconstruction of the chordae tendineae and in mitral valve homograft implantations.
Papillary muscle, chordae tendineae, mitral valve, left ventricular subvalvular apparatus, homograft implantation