What is apical tethering?

What is apical tethering?

Apical displacement of the leaflets and coaptation result from greater tethering force either by reduced closing force and/or augmented tethering force. The tethering force is directly related to the position of the PMs, and outward displacement of the PMs can augment tethering force.

What is coaptation of mitral valve?

The coaptation height was defined as the length between the free edge of the leaflet and the anterior and posterior lobes to left atrial surface level at end-systole stage. Carpentier typing was used to unify the mitral leaflet partition.

What is tenting area of mitral valve?

Mitral valve tenting area (MVTa) is defined as the area enclosed between the atrial surface of the valve leaflets and a line connecting juxtaposed points on the anterior and posterior mitral annulus.

What is mitral valve made of?

The mitral apparatus is composed of the left atrial wall, the annulus, the leaflets, the chordae tendineae, the papillary muscles, and the left ventricular wall. The valve is located obliquely behind the aortic valve.

What does the chordae tendineae attached to?

The chordae tendineae connect the atrioventricular valves (tricuspid and mitral), to the papillary muscles within the ventricles. Multiple chordae tendineae attach to each leaflet or cusp of the valves.

What is leaflet coaptation?

Coaptation length was defined as the extent of overlap between the two leaflets. Any leaflet tissue beyond the area of apposition of two leaflets was not included as coaptation.

What happens when the mitral valve doesn’t close properly?

If a valve doesn’t open or close properly, blood flow through the heart to the body can be reduced. In mitral valve regurgitation, the flaps don’t close tightly. Blood flows backward when the valve is closed, making it harder for the heart to work properly.

Where is the tricuspid annulus measured?

Tricuspid annular dimensions measured at end-diastole in the modified apical four-chamber view to maximise right heart size. Right atrial (RA) major (vertical white line) dimension is from the centre of the tricuspid annulus to the centre of the superior RA wall, parallel to the atrial septum.

What is mitral valve leaflet?

The mitral valve has two leaflets. The anterior leaflet has a semi-circular shape and attaches to two fifths of the annular circumference. There is continuity between the anterior leaflet of the mitral valve and the left and non-coronary cusp of the neighboring aortic valve, referred to as the aortic-mitral curtain.

What is MV leaflet tethering and what causes it?

When the LV dilates the papillary muscles become stretched and displaced, which causes dilatation of the MV annulus. This causes the leaflets to become restricted during systole and not properly coapt (leaflets motion then tethers), causing the regurgitation. Therefore, MV leaflet tethering is a result of secondary/functional MR occurring.

What is the treatment for tricuspid leaflet tethering?

The leaflet tethering has to be adequately addressed surgically to ensure long term durability of the tricuspid valve repair. The most common technique used to address significant tricuspid leaflet tethering is to augment the tricuspid valve leaflet [ 15, 16 ].

What is included in the preoperative assessment of tethering and tethering?

Preoperative assessment of tethering mechanism, degree of leaflet distortion, surface of coaptation, annular dilation, origin and quantification of valve incompetence by echocardiographic means is essential in indicating this surgical option.

What is the meaning of leaflet in medical terms?

Medical Definition of leaflet. : a leaflike organ, structure, or part lipid molecules in a bimolecular leaflet especially : any of the flaps of the biscuspid valve or the tricuspid valve.