Distance between mitral anulus and papillary muscles: Anatomic study in normal human hearts
Distance between mitral anulus and papillary muscles: Anatomic study in normal human hearts
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DOI：
10.1016/s0022-5223(99)70008-5
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发表时间：
1999-10-01
影响因子：
6
通讯作者：
Miki, S
中科院分区：
文献类型：
--
作者：
Sakai, T;Okita, Y;Miki, S
背景：二尖瓣置换术中保留环乳头肌的连续性是很重要的，即使在需要切除二尖瓣的患者中，连续性也可以恢复。方法：直接测量57例正常尸体心脏乳头肌尖端到相应二尖瓣环的距离。结果：前外侧乳头肌尖端距左三角区（10点钟位置：D10）和距壁小叶前、中扇贝间点（8点钟位置：D8）分别为23.5 +/- 3.7 mm和23.2 +/- 3.6 mm。后内侧乳头肌尖端到右三角肌（2点钟位置：D2）和到壁小叶中后扇贝之间点（4点钟位置：D4）的距离分别为23.5 +/- 4.0 mm和23.5 +/- 3.9 mm。4个距离间差异无统计学意义（P = 0.96），每个距离均明显长于相应的腱索（D10 vs前主索：17.2 +/- 3.9 mm）。D8对前裂索：14.5 +/- 3.2 mm， D2对后主索：17.9 +/- 4.3 mm， D4对后裂索：14.9 +/- 3.2 mm；P = 0.0001)，平均距离与二尖瓣环直径有显著的相关性（r = 0.31, P = 0.019）。结论：在正常心脏中，二尖瓣装置的环乳头肌距离在2、4、8、10点钟位置相似，并与二尖瓣环直径相关。
Background: Preservation of the annulo-papillary muscle continuity in mitral valve replacement is important, Even in patients who require excision of the mitral apparatus, the continuity can be restored. However, there is no guide to the proper length for the resuspension, Methods: In 57 normal cadaveric hearts, the distance from the tip of the papillary muscle to its corresponding mitral anulus was directly measured. Results: The distance from the tip of the anterolateral papillary muscle to the left trigone (10-o'clock position: D10) and to the point between the anterior and the middle scallops of the mural leaflet (8-o'clock position: D8) was 23.5 +/- 3.7 mm and 23.2 +/- 3.6 mm, respectively. The distance from the tip of the posteromedial papillary muscle to the right trigone (2-o'clock position: D2) and to the point between the middle and the posterior scallops of the mural leaflet (4-o'clock position: D4) was 23.5 +/- 4.0 mm and 23.5 +/- 3.9 mm, respectively. There was no statistically significant difference among the 4 distances (P = .96), Each distance was significantly longer than the corresponding chordae tendineae (D10 vs the anterior main chorda: 17.2 +/- 3.9 mm. D8 vs the anterior cleft chorda: 14.5 +/- 3.2 mm, D2 vs the posterior main chorda: 17.9 +/- 4.3 mm, and D4 vs the posterior cleft chorda: 14.9 +/- 3.2 mm, respectively; P = .0001), The mean distance had a significant correlation with the mitral annular diameter (r = 0.31, P = .019), Conclusions: In normal hearts, the annulo-papillary muscle distances of the mitral apparatus are similar in 2-, 4-, 8-, and 10-o'clock positions and correlate with the mitral annular diameter.