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Morphometry of chordae tendineae of mitral valves and annulopapillary distance for mitral allografts

Senthil Kumar B, Panneer Selvi G, Rekha G, Rajitha V, Anitha MR.

Abstract
Background: Mitral valve is the complex variable structure with 2 cusps and 2 papillary muscles which are connected
by collagenous structure chordae tendineae supporting the entire free edge of the valvular cusps.

Aims & Objective: To study the morphological and morphometric analysis of chordae tendineae and to compare the
morphometric measurements among cadaveric and autopsied heart specimens of south Indians and the effect of
formalin in causing shrinkage of chordae tendineae. The annulopapillary distances were measured for mitral allografts.

Material and Methods: The prospective study was done on 45 cadaveric and 15 autopsied heart specimens. The left
atrium and left ventricle were cut open and the measurements of the Mitral valve chordae tendineae were taken using
Vernier calliper and recorded. The chordae tendineae was measured from tip of papillary muscles to the edges of the
cusp. The annulopapillary distance was measured from tip of papillary muscles in 2 o', 4 o', 8 o', 10 o' clock positions to
that of mitral annulus. The data’s were analyzed using student’s t test to compare between the cadaveric and autopsied
heart specimens.

Results: Aortic cusp chordae tendineae of both specimens were approximately same 1.6 to 1.8cm, whereas in mural
and commissural cusp mild difference of 2-3mm was observed 1.5 to 1.7 cm. The annulopapillary distance was equal in
both the specimens 2cm. Two heart specimens showed complete absence of commissural chordae and 6 hearts showed
absence of basal chordae.

Conclusion: Many studies were done on morphometry of mitral valve but the present study on morphometry of
chordae tendineae of mitral valve did not show any significant changes among cadaveric and autopsied heart
specimens. The data will be of great use to cardiac surgeons for surgical reconstruction of mitral valves and
annulopapillary distance for mitral allografts.

Key words: Chordae Tendineae; Mitral Valve; Annulopapillary Distance; Cadaveric Heart; Autopsied Heart



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