二尖瓣前乳头肌腱索肌肉化。

IF 1.4 4区 医学 Q2 Medicine Surgical and Radiologic Anatomy Pub Date : 2024-10-01 Epub Date: 2024-08-27 DOI:10.1007/s00276-024-03465-z
Kazzara Raeburn, Maira duPlessis, Marios Loukas
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引用次数: 0

摘要

腱索被描述为纤维胶原结构,以各种方式支撑着心脏房室瓣的瓣叶。腱索由胶原蛋白和弹性纤维组成。它们与瓣叶游离缘的心室侧相连,阻碍瓣叶在收缩过程中摆动回到心房腔内。二尖瓣腱索有多种分类系统。据我们所知,我们报告了一种文献中尚未描述过的变异腱膜。该变异体仅存在于二尖瓣前乳头肌上,并不显示腱索的特征性外观。观察到的肌纤维从比平常更大的二尖瓣前乳头肌延伸出来,插入前叶的粗糙区。几条腱性初级和次级真叶腱索从前方乳头肌的顶端部分伸出,插入前叶的游离边缘和粗糙区。在收缩过程中,这种肌肉绒毛的收缩可能会破坏瓣膜关闭的力学结构,导致二尖瓣反流。此外,在心肌梗塞时这一结构可能会破裂,导致瓣膜功能障碍。腱索和乳头肌之间的发育联系可以解释本病例中观察到的腱索肌肉异常。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Muscularization of the chordae tendinea of the mitral anterior papillary muscle.

The chordae tendineae, described as fibro-collagenous structures, support the leaflets of the atrioventricular valves of the heart in various ways. The chordae tendineae are composed of collagen and elastic fibers. They connect to the ventricular side of the valve leaflets' free border and hinder the leaflets from swinging back into the atrial cavity during systole. Mitral valve chordae tendineae have been classified using a variety of classification systems. To our knowledge, we report a variant chordae tendinea that has yet to be described in the literature. The variant, present only on the mitral anterior papillary muscle, did not show the characteristic appearance of the chorda tendineae. Muscular fibers were observed extending from a larger than usual mitral anterior papillary muscle, inserting into the rough zone of the anterior leaflet. Several tendinous primary and secondary true leaflet chordae emerge from the apical portion of the anterior papillary muscle, inserting into the anterior leaflet's free edge and rough zone. Contraction of this muscular chorda during systole could disrupt the mechanics of valvular closure and result in possible regurgitation across the mitral valve. Additionally, this structure may be subject to rupture during myocardial infarction, leading to valvular dysfunction. The developmental connection between the chordae and papillary muscles could explain the anomalous muscularization of the chordae tendineae observed in this case.

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来源期刊
Surgical and Radiologic Anatomy
Surgical and Radiologic Anatomy Medicine-Pathology and Forensic Medicine
CiteScore
2.40
自引率
14.30%
发文量
0
期刊介绍: Anatomy is a morphological science which cannot fail to interest the clinician. The practical application of anatomical research to clinical problems necessitates special adaptation and selectivity in choosing from numerous international works. Although there is a tendency to believe that meaningful advances in anatomy are unlikely, constant revision is necessary. Surgical and Radiologic Anatomy, the first international journal of Clinical anatomy has been created in this spirit. Its goal is to serve clinicians, regardless of speciality-physicians, surgeons, radiologists or other specialists-as an indispensable aid with which they can improve their knowledge of anatomy. Each issue includes: Original papers, review articles, articles on the anatomical bases of medical, surgical and radiological techniques, articles of normal radiologic anatomy, brief reviews of anatomical publications of clinical interest. Particular attention is given to high quality illustrations, which are indispensable for a better understanding of anatomical problems. Surgical and Radiologic Anatomy is a journal written by anatomists for clinicians with a special interest in anatomy.
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