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Mitral Isthmus anatomy: Detailed examination and classification proposal

IF 2.3 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Pathology Pub Date : 2025-01-30 DOI:10.1016/j.carpath.2025.107723

Buse Naz Çandır Gürses , Kader Yılar , Çağla Ergin , Özcan Gayretli

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引用次数: 0

Abstract

Aim

The aim of this study was to investigate the anatomical features of the mitral isthmus (MI) line, the vessels located there and their localisation in the MI line.

Methods

MI length and wall thickness were measured in a total of 65 autopsied fresh hearts. The distances of the vessels at the level of MI to the left inferior pulmonary vein (LIPV), mitral annulus (MA), endocardium surface (ES) and lateral adipose tissue (LAT) were recorded.

Results

The mean linear length of MI and left atrial wall thickness were 49.6 ± 9.9 mm and 3.9 ± 1.2 mm, respectively. GCV and LCx are approximately 1 cm from MA, 4 cm from LIPV, 5-6 mm from ES and 7 mm from LAT. Great cardiac vein (GCV) was found to be located in the MI line in 100 %, left circumflex artery (LCx) in 60 %, and vein of Marshall (VOM) in 63.1 % of cases. Presence of only GCV was recorded as Type-1 (18.5 %), GCV and LCx as Type-2 (18.5 %), GCV and VOM as Type-3 (21.5 %) and presence of all three as Type-4 (41.5 %). LCx located below the GCV was recorded as Type-A (59 %), above the GCV as Type-B (25.6 %), and at the same level but with LCx on the endocardial surface as Type-C1 (12.8 %) and on the epicardial surface as Type-C2 (2.6 %).

Conclusion

This study proves that the anatomy of MI is far from standardised and helps to raise awareness of the vascular pattern that may be encountered prior to ablation intervention.

查看原文本刊更多论文

二尖瓣峡解剖：详细检查和分类建议。

目的：本研究的目的是探讨二尖瓣峡（MI）线的解剖特征，位于那里的血管及其在MI线的定位。方法：测定65例新鲜解剖心脏心肌梗死长度和壁厚。记录心肌水平血管到左下肺静脉（LIPV）、二尖瓣环（MA）、心内膜表面（ES）和外侧脂肪组织（LAT）的距离。结果：心肌梗死线长平均49.6±9.9 mm，左房壁厚度平均3.9±1.2 mm。GCV和LCx距MA约1厘米，距LIPV约4厘米，距ES约5-6毫米，距LAT约7毫米。心脏大静脉（GCV）位于心肌梗死线（100%），左旋动脉（LCx）位于心肌梗死线（60%），马歇尔静脉（VOM）位于心肌梗死线（63.1%）。仅GCV为1型（18.5%），GCV和LCx为2型（18.5%），GCV和VOM为3型（21.5%），三者均为4型（41.5%）。位于GCV下方的LCx为a型（59%），位于GCV上方的LCx为b型（25.6%），位于相同水平但心内膜表面的LCx为c1型（12.8%）和心外膜表面的LCx为c2型（2.6%）。结论：本研究证明心肌梗死的解剖结构远未标准化，有助于提高对消融介入前可能遇到的血管形态的认识。

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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来源期刊

Cardiovascular Pathology

Cardiovascular Pathology 医学-病理学

CiteScore

7.50

自引率

2.70%

发文量

71

审稿时长

18 days

期刊介绍： Cardiovascular Pathology is a bimonthly journal that presents articles on topics covering the entire spectrum of cardiovascular disease. The Journal''s primary objective is to publish papers on disease-oriented morphology and pathogenesis from clinicians and scientists in the cardiovascular field. Subjects covered include cardiovascular biology, prosthetic devices, molecular biology and experimental models of cardiovascular disease.

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