Anatomy of the Human Tricuspid Valve

Abstract

INTRODUCTION:
Despite considerable clinical interest in th disease of the tricuspid valve (Perloff & Harvey, 1960; Carpentier et al., 1974 and Mahapmra et at., 1978), studies on time structure of this valve complex are limited (Silver et al., 1971). This is in contrast to the large repertory of work on the mitral valve (Ranganathan et at., 1970; Lam et al., 1970; Becker & De Wit, 1979 and Wenink & Giltenberger - de Groot, 1986).

MATE RiALS AND METHODS:
A total of 43 hearts àbtained from embalmed cadavers, 37 males and 6 females were examined. However, a detailed study of the number, size and attachments of the papillae, chordae tendineae and leaflets of the tricuspid valve was carried out in 25 hearts; the remaining 18 hearts were disc arded because of poor perfusion and preservat ion. The hearts belonged to individuals aged 15 to 50 years who died of accidental or natural causes and had not suffered from any major cardiopuln’onary disease.

RESULTS CUSPS/LEAFLETS:

The ditrmensions of the posterior and septal cusps were significantly variable s compared to those of the anterior cusp. On average, the anterior cusps were relatively larger than the posterior and septal cusps; the latter two were approximately equal in size. The septal and posterior cusps were semicircular in contrast to the cuadrangu1ax shape of the anterior cusp: The site of origin of the anteroposterior, posteroseptal and anteroseptal commissural chordee varied considerably. See table II for distribution of these chordate in 25 hearts examined in this study.

DISCUSSION:

In this study, we have focused attention mainly on the investigation of the anatomic features and. variations within normal range seen in the human tricuspid valve. As stated in the introduction, with the exception of the classical work of Silver et al. (1971), studies on the gross morphological components of this valve are limited. The most common aetiology of the tricuspid valve disease appears to be congenital (Becker and Anderson, 1981). This is commensurate with the observed preponderance of variability in the components of the tricuspid valve as compared to the mitral valve. Hence, what is normal in the tricuspid valve may not be so in the mitral valve. The danger in readily applying concepts of anomaly established from mitral valve studies to the tricuspid valve based on purely embryo logical studies should be obvious (Anderson, 1986).