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| Year : 2007
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| Chordae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet - an unusual presentation. what is unusual? |
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Sanjay Goel
Department of Anaesthesia and Perioperative Medicine London Health Sciences Centre University Hospital, London Ontario., Canada
Click here for correspondence address and
email
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How to cite this article:
Goel S. Chordae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet - an unusual presentation. what is unusual?. Ann Card Anaesth 2007;10:156 |
How to cite this URL:
Goel S. Chordae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet - an unusual presentation. what is unusual?. Ann Card Anaesth [serial online] 2007 [cited 2021 Jan 18];10:156. Available from: https://www.annals.in/text.asp?2007/10/2/156/37945 |
To,
The Editor,
I read with great interest the article by Tempe and colleagues [1] and seek a few clarifications.
The article mentions that the chordae tendineae from the postero-medial papillary muscle inserting into the anterior mitral leaflet is an unusual presentation. I am not clear what is unusual about it? Secondly, Authors have mentioned that chordae tendinae from each papillary muscle insert into the corresponding half of the mitral leaflet. Do they mean that chordae tendineae from antero-lateral and postero-medial papillary muscles insert to anterior and posterior leaflets of the mitral valve respectively?
There are three segmental nomenclatures commonly employed to describe the anatomy of the mitral valve leaflets, the American Society of Echocardiography (ASE)- Society of Cardiovascular Anesthesiologists (SCA) i.e. Carpentier, the Anatomic, and the Duran. [2]
Amongst them, ASA-SCA classification is most commonly used and well accepted. This classification divides anterior and posterior leaflets of the mitral valve into three segments as A1, A2, A3 and P1, P2, P3 respectively. Chordae tendineae from antero-lateral papillary muscle insert into A1, P1, and one part of the A2 and P2 segments of the mitral leaflets, whereas segments A3, P3, and other part of A2 and P2 receive chordae tendineae from postero-medial papillary muscle. [2],[3] It is now well accepted by all classifications that chordae tendineae from the heads of both anterolateral and postero-medial papillary muscles attach to the corresponding halves of the anterior as well as posterior leaflets of the mitral valve. [4]
In addition, transgastric long axis view of the mitral valve shows P2 and P3 segments of the posterior mitral leaflet as well as A2 and A3 segments of the anterior mitral leaflet. Therefore, it is not uncommon to see the view where chordae tendineae from the postero-medial papillary muscle is inserting into the part of both A2 and P2 segments of the mitral valve leaflet.
 References | |  |
| 1. | Tempe DK, Datt V, Banerjee A, Gandhi A. Choardae tendineae from posteromedial papillary muscle inserting into the anterior mitral leaflet - An unusual presentation. Ann Card Anaesth 2007; 10: 63.  [PUBMED] [FULLTEXT] |
| 2. | Savage RM, Shiota T, Stewart JW, Wallace L, Gillinov AM. Assessment in mitral valve surgery, In: Savage RM, Aronson S, Comprehensive textbook of intraoperative transesophageal echocardiography, Philadelphia, Lippincott Williams & Wilkins 2005; pp 453-454. |
| 3. | Carpentier AF, Lessana A, Relland J, et al: The "PhysioRing': An advanced concept in mitral valve annuloplasty. Ann Thorac Surg 1995; 60: I 177-I 186 . |
| 4. | Bollen BA, Hong He Lou, Oury JH, et al. A systematic approach to intraoperative transesophageal echocardiographic evaluation of the mitral valve with anatomic correlation. J Cardiothorac Vasc Anesth 2000; 14: 330-338. |
Correspondence Address:
Sanjay Goel
Department of Anaesthesia and Perioperative Medicine London Health Sciences Centre University Hospital, London Ontario.
Canada
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0971-9784.37945
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