The Anatomy of the Mitral Apparatus and Relevance to Septal Therapy PDF
Preview The Anatomy of the Mitral Apparatus and Relevance to Septal Therapy
The Anatomy of the Mitral Apparatus and Relevance to Septal Therapy Harry M. Lever, MD Medical Director of the Hypertrophic Cardiomyopathy Clinic Cleveland Clinic Echocardiographic Assessment The echocardiogram is the key tool to assess : The anatomy and physiology of this disease which then helps to determine the management: Medical Surgical Alcohol Septal Ablation Cleveland Clinic Hypertrophic Cardiomyopathy is not just a thick septum!! Cleveland Clinic The Syndrome of Outflow Tract Obstruction OCM Obstructive Cardiomyopathy Cleveland Clinic Anatomy • Ventricular Muscle • Papillary Muscles • Chordae Tendineae • Mitral Valve Cleveland Clinic Hypertrophic Cardiomyopathy There is a complex interaction of the mitral valve, the papillary muscles, chordae tendineae, and the ventricular septum that causes obstruction and mitral regurgitation. Cleveland Clinic Anatomy Ventricular Muscle • Hypertrophy: present or absent Ø Location – Proximal Septum – Whole Septum – Concentric – Lateral Wall – Apex Cleveland Clinic Anatomy Papillary Muscles • Number of Papillary Muscles • Location Ø Medial Ø Lateral Ø Apical • Number of Heads • Size • Strength Ø How well does it anchor the Mitral Valve? Cleveland Clinic Hypertrophic Cardiomyopathy • Role of the Papillary Muscles • Direct attachment to the leaflets • Anterior or apical displacement • Attachment to the septum Cleveland Clinic Development of the Mitral Valve Oosthoek P. W. et al.; J Thorac Cardiovasc Surg 1998;116:36-40 Cleveland Clinic Copyright ©1998 The American Association for Thoracic Surgery
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