Anatomy Of The Mitral Valve

It is good to have basic knowledge of the mitral valve anatomy. It is briefly described below with some line diagrams -






1. Leaflets - Anterior and posterior

• Posterior leaflet - divided into 3 scallops by indentations - P1,2,3
• Anterior leaflet - divided into 3 scallops to correspond to posterior - A1,2,3. This division is not by indentations, but is done so to correspond the posterior leaflet scallops.
• Leaflet closure contact line is called coaptation line. Leaflet overlap is zone of apposition

2. Mitral annulus

• Junction between left atrium and ventricle
• Diameter of >35 mm is indicative of dilatation or when ratio of annulus:anterior leaflet ratio >1.3 (measured in diastole)²

3. Chordae tendinae and papillary muscles

• 2 papillary muscles - anterolateral and posteromedial
• Chordae attached from papillary muscle to leaflet edges
• Rupture or infarction can result in mitral regurgitation

References

1. Patrizio Lancellotti, Luis Moura, Luc A. Pierard, Eustachio Agricola, Bogdan A. Popescu,Christophe Tribouilloy, Andreas Hagendorff, Jean-Luc Monin, Luigi Badano,Jose L. Zamorano, on behalf of the European Association of Echocardiography, Document Reviewers:, Rosa Sicari, Alec Vahanian, and Jos R.T.C. Roelandt. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease)Eur J Echocardiogr (2010) 11(4): 307-332
2. Caldarera I, Van Herwerden LA, Taams MA, Bos E, Roelandt JR. Multiplane transoesophageal echocardiography and morphology of regurgitant mitral valves in surgical repair. Eur Heart J 1995;16:999-1006