Anatomy of Left Atrioventricular Valve (Mitral Valve) Leaflets in Adult Indian Cadavers

The atrioventricular valve is the most commonly repaired valve of the heart. Interventional procedures like annuloplasties, valvotomy/valvuloplasty, repair/replacement of the valve for regurgitation or prolapse are increasing by the day. This necessitates a clear understanding of the mitral valve anatomy. The present study is an attempt to revisit the anatomy of mitral valve. The present study was conducted on 34 adult embalmed heart specimens. Based on the newly defined criteria, observations were made on: 1) Number of commissures and their positions, 2) Number and position of leaflets, 3) Number and position of minor commissures, 4) Annular circumference (AC), 5) Length of annular attachment of each leaflet (LAA), 6) Maximum width of coapted/folded margin (FM) of the anterior and posterior leaflet, 7) The surface area of each leaflet (SA). The observations were analyzed statistically. The findings of the present study and the subsequent statistical analysis offer a dynamic concept of the anatomy of mitral valve leaflets. It suggests that the valvular anatomy depends upon a complex interplay of various valve components. The extra leaflets tend to occur when annular circumference increases and is not appropriately compensated by various valvular elements. The different methodology adopted in the present study and the interpretations deduced hereupon, shall dispel the existing ambiguities in the description of the leaflets and improve our understanding of the structure and function of the mitral valve complex.