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Quantitative morphology of the normal human tricuspid valve: Autopsy study of 24 cases
Author(s) -
Seccombe John F.,
Cahill Donald R.,
Edwards William D.
Publication year - 1993
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.980060402
Subject(s) - tricuspid valve , medicine , chordae tendineae , autopsy , leaflet (botany) , anatomy , anterior surface , cardiology , mitral valve , biology , paleontology
Objective: To describe thoroughly and quantitatively the morphologic features of the human tricuspid valve, to define and classify classify certain prominent normal variations, and to offer a clear and concise terminology for describing its morphology. Background. In recent years there has been growing interest in the tricuspid valve. Noninvasive imaging is now commonplace and remarkably detailed. Surgical interventions involving the tricuspid valve have become increasingly common. These factors underscore the need variations. Methods. Quantitative and anatomic features of the tricuspid valve were studied in 24 normal hearts at autopsy from subject evenly distributed by age and sex. Leaflet length, surface area, chordal number, and leaflet morphology were recorded. Results. Valves demonstrated some degree of leaflet subdivision in 92% of cases. Mean tricuspid valve length was 11.3 ± 0.1 cm and the surface area was 21.0 ± 1.1 cm 2 . Mean lengths and surface areas were similar for the anterior, posterior, and septal leaflets (38–42 mm and 5.9–7.8 cm 2 , respectively). However, for a given valve, the longest leaflet could be twice the length and three times the area of the smallest. Calculated valvular diameter was 2.13 ± 0.03 cm/m 2 . The tricuspid valve was served by and average of 170 ± 36 chordae tendineae, 49% inserted on the free edge of the valve, 44% on the undersurface, and 7% on the basal regions. Chordal density (number of chordae/cm 2 ) was greater in women than men (9.9 ± 0.5 vs. 7.3 ± 0.7 chordae/cm 2 , P < 0.02). The septal leaflet had the greatest chordal density and the anterior leaflet the lowest (12.7 ± 0.9 vs. 5.9 ± chordae/cm 2 ). Conclusions. The concept of chordal density for the tricuspid valve has not been previously described and may be clinically relevant in the pathogensis of valvular prolapse. Modifications of existing tricuspid valve nomenclature are suggested. © 1993 Wiley‐Liss, Inc.