REVIEW PAPER
Participation of atrioventricular valves chordae tendineae pathology in a patient’s clinical presentation
1
Students’ Scientific Association, Department of Human Anatomy, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
2
Department of Human Anatomy, Faculty of Medicine, Medical University of Silesia, Katowice, Poland
These authors had equal contribution to this work
Submission date: 2024-01-14
Final revision date: 2024-04-16
Acceptance date: 2024-05-14
Publication date: 2024-06-29
Corresponding author
Zuzanna Szewczyk
Zuzanna Szewczyk Students’ Scientific Association Department of Human Anatomy Faculty of Medicine Medical University of Silesia Katowice, Poland
Zuzanna Szewczyk Students’ Scientific Association Department of Human Anatomy Faculty of Medicine Medical University of Silesia Katowice, Poland
Medical Studies 2024;40(2):201-207
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The anatomically correct chordae tendineae originate from the apical part of the papillary muscles of the ventricles and attach to the corresponding free margins of the atrioventricular valves. Together with the papillary muscles, they contribute to the effective contraction of the ventricles, creating the so-called “annular-ventricular continuity”.
Aim of the research:
This publication aimed to evaluate and analyse the impact of chordae tendineae pathology of the atrioventricular valves on the clinical presentation of a patient.
Material and methods:
A systematic review of the literature was performed in the PubMed, Web of Science, and Scopus databases and according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Results and conclusions:
This review allowed us to distinguish 6 groups of characteristic pathological lesions of chordae tendineae such as thickening, elongation, shortening, fibrosis, complete absence, or histopathological changes of the chordae tendineae. Most of the cases resulted from congenital underlying diseases, and treatment mainly consisted of surgical correction.
The anatomically correct chordae tendineae originate from the apical part of the papillary muscles of the ventricles and attach to the corresponding free margins of the atrioventricular valves. Together with the papillary muscles, they contribute to the effective contraction of the ventricles, creating the so-called “annular-ventricular continuity”.
Aim of the research:
This publication aimed to evaluate and analyse the impact of chordae tendineae pathology of the atrioventricular valves on the clinical presentation of a patient.
Material and methods:
A systematic review of the literature was performed in the PubMed, Web of Science, and Scopus databases and according to the PRISMA guidelines (Preferred Reporting Items for Systematic Reviews and Meta-Analyses).
Results and conclusions:
This review allowed us to distinguish 6 groups of characteristic pathological lesions of chordae tendineae such as thickening, elongation, shortening, fibrosis, complete absence, or histopathological changes of the chordae tendineae. Most of the cases resulted from congenital underlying diseases, and treatment mainly consisted of surgical correction.
REFERENCES (40)
1.
Roberts WC, Cohen LS. Left ventricular papillary muscles. Description of the normal and a survey of conditions causing them to be abnormal. Circulation. 1972 Jul; 46(1): 138-154.
2.
Athanasiou T, Chow A, Rao C, Aziz O, Siannis F, Ali A, Darzi A, Wells F. Preservation of the mitral valve apparatus: evidence synthesis and critical reappraisal of surgical techniques. Eur J Cardiothorac Surg. 2008 Mar; 33(3): 391-401.
3.
de Vlaming A, Sauls K, Hajdu Z, Visconti RP, Mehesz AN, Levine RA, Slaugenhaupt SA, Hagège A, Chester AH, Markwald RR, Norris Russell A. Atrioventricular valve development: new perspectives on an old theme. Differentiation. 2012 Jul; 84(1): 103-116.
4.
Goodwin RL, Kheradvar A, Norris RA, Price RL, Potts JD. Collagen fibrillogenesis in the mitral valve: it’s a matter of compliance. J Cardiovasc Dev Dis. 2021 Aug; 8(8): 98.
5.
Page MJ, Moher D, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Akl EA, Bren- nan SE, Chou R, Glanville J, Grimshaw JM, Hróbjarts- son A, Lalu MM, Li T, Loder EW, Mayo-Wilson E, McDonald S, McGuinness LA, Stewart LA, Thomas J, Tricco AC, Welch VA, Whiting P, McKenzie JE. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ. 2021 Mar; 372: n160.
6.
Igarashi T, Takase S, Satokawa H, Wakamatsu H, Kurosawa H, Yokoyama H. Left ventricular noncompaction complicated by mitral valve prolapse: report of a case. Surg Today. 2013 Jul; 43(7): 818-820.
7.
Takaya T, Takeuchi Y, Okamoto M, Hata K, Kijima Y, Nakajima K, Kita T, Ito M, Nakajima H, Takaoka R, Nomu- ra T, Iwahashi K, Kawashima S, Seo T. Mitral regurgitation resulting from the consecutive multiple perforations by infective endocarditis mimicking the isolated anterior mitral cleft. J Cardiol. 2008 Oct; 52(2): 159-162.
8.
Nishi H, Mitsuno M, Ryomoto M, Miyamoto Y. Severe mitral regurgitation due to cardiac amyloidosis--a rare reason for ruptured chordae. Interact Cardiovasc Thorac Surg. 2008 Dec; 7(6): 1199-1200.
9.
Masugata H, Mizushige K, Senda S, Kinoshita A, Nozaki S, Matsuo H, Kohno M. Physical properties of the mitral valve tissue assessed by tissue sound speed in cardiac amyloidosis: relationship to the severity of mitral regurgitation. Ultrasound Med Biol. 2000 Sep; 26(7): 1191-1198.
10.
Ammar KA, Khandheria BK, Bajwa T, Port SC, Allaqa- band S, Jain R, Neitzel G, Tajik AJ. Cardiac amyloidosis presenting as severe mitral regurgitation. JACC Cardiovasc Imaging. 2016 Aug; 9(8): 1003-1006.
11.
Laurence DW, Johnson EL, Hsu MC, Baumwart R, Mir A, Burkhart HM, Holzapfel GA, Wu Y, Lee CH. A pilot in silico modeling-based study of the pathological effects on the biomechanical function of tricuspid valves. Int J Numer Method Biomed Eng. 2020 Jul; 36(7): e3346.
12.
Ikeno Y, Yokawa K, Henmi S, Nakai H, Yamanaka K, Inoue T, Tanaka H, Tanaka H, Hirata K, Okita Y. A successful report of mitral valve repair for parachute-like mitral valve in adult. Gen Thorac Cardiovasc Surg. 2020 Mar; 68(3): 287-289.
13.
Duan QJ, Duan CT, Dong AQ, Cheng HF. Parachute mitral valve associated with reticular chordae tendineae in an adult: case report. J Cardiothorac Surg. 2021 Apr; 16(1): 72.
14.
Yuan SM. Parachute mitral valve: Morphology and surgical management. Turk Gogus Kalp Damar Cerrahisi Derg. 2020 Jan; 28(1): 219-226.
15.
Lin XF, Xu Z, Zheng ZH, Wang T, Dai XF. Early clinical outcomes of thoracoscopic mitral valvuloplasty: the first 90 cases. Heart Surg Forum. 2022 Sep; 25(5): E692-E697.
16.
Mohan JC, Shukla M, Mohan V, Sethi A. Parachute mitral valve and Pacman deformity of the ventricular septum in a middle-aged male. Indian Heart J. 2016 Sep; 68 Suppl 2 (Suppl 2): S126-S130.
17.
Babu NS, Vimala LR, Varghese L, George OK. An arcade in the heart: multimodality imaging. Ann Pediatr Cardiol. 2020 Jan-Mar; 13(1): 95-97.
18.
Purvis JA, Kennedy V, McNeill AJ. Don’t stop at two. Int J Cardiovasc Imaging. 2010 Apr; 26(4): 369-371.
19.
Akamatsu A, Nomoto R, Nagao H, Murakami H, Nonaka I, Tara M, Kato M. Adult form acid maltase deficiency: a case report. Jpn J Med. 1982 Jul; 21(3): 203-209.
20.
van Leeuwen K, Fast JH, Deppenbroek JH, Skotnicki SH. Abnormal echoes in the left ventricular outflow tract caused by ruptured chordae tendineae of the mitral valve. Chest. 1982 Jan; 81(1): 103-105.
21.
Sinfield S, Ranasinghe S, Wang S, Mendoza F, Khoynezhad A. Shone’s complex and aortic dissection: case report and review of a rare, underdiagnosed congenital heart disease. J Cardiothorac Surg. 2022 Feb; 17(1): 21.
22.
Taverna S, Cammarata G, Colomba P, Sciarrino S, Zizzo C, Francofonte D, Zora M, Scalia S, Brando C, Lo Curto A, Marsana EM, Olivieri R, Vitale S, Duro G. Pompe disease: pathogenesis, molecular genetics and diagnosis. Aging (Albany NY). 2020 Aug; 12(15): 15856-15874.
23.
Rajani R, Klein JL. Infective endocarditis: a contemporary update. Clin Med (Lond). 2020 Jan; 20(1): 31-35.
24.
Shiraishi Y, Kohno T, Fujii-Nishimura Y, Shimoda M, Ikeda Y, Nakajima K, Nishiyama T, Nishiyama N, Murata M, Maekawa Y, Sano M, Fukuda K. Endomyocardial fibrosis: missing tricuspid valve and Fontan-like circulation. Heart Vessels. 2016 Sep; 31(9): 1579-1582.
25.
Lin TH, Yang SF, Chiu CC. Matrix metalloproteinase-1 mitral expression and -1607 1G/2G gene promoter polymorphism in mitral chordae tendinae rupture. Transl Res. 2013; 161(5): 406-413.
26.
Seth S, Thatai D, Sharma S, Chopra P, Talwar KK. Clinico-pathological evaluation of restrictive cardiomyopathy (endomyocardial fibrosis and idiopathic restrictive cardiomyopathy) in India. Eur J Heart Fail. 2004 Oct; 6(6): 723-729.
27.
Higuchi M, Mitomi K, Chiba Y. Shortened chordae tendineae of the tricuspid valve with right ventricular dysfunction caused by acute myocarditis lead to cardiogenic shock during pericardial drainage: a case report. Oxf Med Case Reports. 2022 Sep; 2022(9): omac097.
28.
Wang X, Xia X, Huang W, Li X, Liu Y. Anomalous origin of the left coronary artery from the pulmonary artery as a rare cause of mitral valve prolapse: a case report. BMC Cardiovasc Disord. 2022 Jul; 22(1): 304.
29.
Wang Y, Ye L, Yin L, Zeng J. Hypertrophic angulation deformity of the basal interventricular septum combined with abnormality of the papillary muscle and chordae tendineae. Cardiovasc J Afr. 2017 Jan; 28(1): e1-e3.
30.
Wilcox CS, Testani JM, Pitt B. Pathophysiology of diuretic resistance and its implications for the management of chronic heart failure. Hypertension. 2020 Oct; 76(4): 1045-1054.
31.
Peńa E, Nguyen ET, Merchant N, Dennie C. ALCAPA syndrome: not just a pediatric disease. Radiographics. 2009 Mar-Apr; 29(2): 553-565.
32.
Maron BJ, Sherrid MV, Haas TS, Lindberg J, Kitner C, Lesser JR. Novel hypertrophic cardiomyopathy phenotype: segmental hypertrophy isolated to the posterobasal left ventricular free wall. Am J Cardiol. 2010 Sep; 106(5): 750-752.
33.
Federici D, Palmerini E, Lisi M, Centola L, Chiavarelli M, Mondillo S. Congenital mitral disease: anomalous mitral arcade in a young man. Ann Thorac Surg. 2010 Feb; 89(2): 629-631.
34.
Mohan JC, Shukla M, Mohan V, Sethi A. Spectrum of congenital mitral valve abnormalities associated with solitary undifferentiated papillary muscle in adults. Indian Heart J. 2016 Sep-Oct; 68(5): 639-645.
35.
Caciolli S, Gelsomino S, Fradella G, Bevilacqua S, Favilli S, Gensini GF. Severe hypoplasia of the posterior mitral leaflet. Ann Thorac Surg. 2008 Dec; 86(6): 1978-1979.
36.
Kudo M, Yozu R, Aeba R, Kokaji K, Kimura N, Iwanaga S. A case report of surgical correction for congenital mitral regurgitation with subvalvular apparatus abnormality. Gen Thorac Cardiovasc Surg. 2008 Jan; 56(1): 36-38.
37.
Singh R, Wang M. A rare encounter of mitral arcade with anomalous papillary muscles. Cureus. 2022 Jan; 14(1): e21253.
38.
Cavalcante JL, Barboza JS, Lever HM. Diversity of mitral valve abnormalities in obstructive hypertrophic cardiomyopathy. Prog Cardiovasc Dis. 2012 May-Jun; 54(6): 517-522.
39.
Bacich D, Braggion G, Faggian G. Hypoplasia of the posterior mitral leaflet: a rare cause of mitral regurgitation in adulthood. Echocardiography. 2017 Jun; 34(6): 949-950.
40.
Jang DH, Yoo JS. Chordae tendineae approximation technique for severe tricuspid regurgitation with severe leaflet tethering using a totally endoscopic beating-heart strategy: a case report. J Chest Surg. 2023 Jan; 56(1): 56-58.
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| eISSN: | 2300-6722 |
| ISSN: | 1899-1874 |
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