Measurement of the Tricuspid and the Mitral Valve in Adult Human Heart: A Cadaveric Study

Abstract

The human heart valve is an integral structure and the valvular heart disease is one of the most common disease of the heart. Such cardiac disease require repair of the valve and valve replacement surgery where the patient’s diseased valve is replaced by a prosthetic valve. The aim of this study was to measure the annular circumferences and diameters of tricuspid and mitral valves in cadavers. A morphometric study was conducted in Department of Anatomy at Nepal Medical College and Teaching Hospital where total 50 cadaveric hearts were taken up for the study. The tricuspid and the mitral valves were exposed by dissection method. Measurements were taken by using a thread and a digital vernier caliper and obtained data were analysed by using SPSS-16. The mean, frequency and standard deviation of circumferences and diameters of both tricuspid and the mitral valves were analysed and were found as (a) The mean annular circumference of tricuspid valve was 11.22 ± 0.20 cm (b) The mean diameter of tricuspid valve was 2.33 ± 0.04 cm. (c) The mean annular circumference of mitral valve was 9.22 ± 1.49 cm (d) the mean diameter of mitral valve was 2.01 ± 0.27 cm. There were few literatures available on the study of cadaveric heart valves in Nepal thus this study will provide a guideline to the clinicians, radiologists and also to cardiothoracic surgeons performing various valve surgeries to assess the prosthetic valve of appropriate size and to the anthropologists also to maintain a standardized data on cardiac valves as well.

Comparison of Heart Valve Circumference Examined Before and After 10% Formalin Fixation

“…However, the data in the previous studies showed some different results compared with this study. Before formalin fixation, the average heart valve circumference in this study was slightly higher than in almost all the previous studies [5][6][7][8][9][10][11][12][13][14] , but lower than that reported by Tei et al 15 and coincided with those reported by Jatene et al 8 and Alison et al 23 Nevertheless, the average heart valve circumference after formalin fixation was slightly lower or similar to the above-mentioned studies. Why there was such a difference between our study and previous studies might be explained by the different socio-economic status and population groups from which the hearts were obtained as well as by the factors affecting formalin fixation, as mentioned above.…”

“…16 Many studies have been carried out in formalinfixed hearts rather than fresh human hearts. 6,[9][10][11]13,15 Formalin is widely used to preserve tissues for routine histological examination. The most common formula is 10% formalin, consisting of 3.7% formaldehyde in water with 1% methanol.…”

“…Currently, there is no standard method to measure heart valve circumference. With reference to previous studies [5][6][7][8]10,12,13 , the thread and ruler technique was the most popular practice to evaluate the heart valve circumference. Because none of the above-mentioned studies provided data on direct measurement, no comparisons can be made.…”

“…Several studies from a variety of countries and based on different ethnicities have been performed to find the average heart valve circumference to aid more accurately estimating the circumference needed for an artificial heart valve. [5][6][7][8][9][10][11][12][13][14][15] In general, previous studies took measurements on formalin-fixed hearts. However, it is well known that formalin fixation can shrink fresh tissues in an unpredictable manner.…”