ABSTRACT
Introduction: The unimpeded forward flow of blood across the mitral orifice depends upon a coordinatedinteraction between the mitral annulus, leaflets, chordae tendinae & papillary muscle. Knowledge about thenormal anatomy of mitral valve annular morphometry is important for assessing the valve pathologies and alsoin valve replacement surgery for a deceased valveMaterials and methods: 50 heart of embalmed adult human cadaver of both sex aged between 20-70 years weretaken from the department of anatomy, VIMS & RC. Parameters measured were annular diameter, circumference,area of mitral valve by using vernier caliper, measuring scale, cotton thread & magnifying lens.Results: In the present study mean value of mitral valve were, circumference of mitral valve was 8.19±1.01cm inmales, 7.76±0.99 cms in females, diameter was 3.10±0.40 cm in males & 3.26±0.48 cm in females, area of mitralvalve was 5.45±1.34 cm2in males & 4.89±1.20 cm2 in females. All the parameters of mitral valve annulus likecircumference, diameter & area of valve was more in males except in females the diameter was more. There wasno significant difference between male & female values of mitral valve annulus.Conclusion: Knowledge of normal measurements of the component parts of the mitral valve is essential for thesurgeon during operation to assess the exact mechanical reason for valve insufficiency & in development &manufacture of prostheses for valvuloplasty
ABSTRACT
Current guidelines recommend screening cirrhotic patients with an endoscopy to detect esophageal varices and to institute prophylactic measures in patients with large esophageal varices. In this study, we aimed at identifying non-endoscopic parameters that could predict the presence and grades of esophageal varices. In a prospective study, 229 newly diagnosed patients with liver cirrhosis, without a history of variceal bleeding, were included. Demographic, clinical, biochemical and ultrasonographic parameters were recorded. Esophageal varices were classified as small and large, at endoscopy. Univariate analysis and multivariate logistic regression analysis were done to identify independent predictors for the presence and grades of varices. Of the 229 patients [141 males; median age 42 years; range 17-73 years] with liver cirrhosis, 97 [42.3%] had small and 81 [35.4%] had large varices. On multivariate analysis, low platelet count [Odd's Ratio [OR], 4.3; 95% confidence interval [CI], 1.2-14.9], Child Pugh class B/C [OR, 3.3; 95% CI, 1.8-6.3], spleen diameter [OR, 4.3; 95% CI, 1.6-11.9] and portal vein diameter [OR, 2.4; 95% CI, 1.1-5.3] were independent predictors for the presence of varices. Likewise, for the presence of large esophageal varices, low platelet count [OR, 2.7; 95% CI, 1.4-5.2], Child Pugh class B/C [OR, 3.8; 95% CI, 2.3-6.5] and spleen diameter [OR, 3.1; 95% CI, 1.6-6.0] were the independent risk factors. The presence and higher grades of varices can be predicted by a low platelet count, Child-Pugh class B/C and spleen diameter. These may be considered as non-endoscopic predictors for the diagnosis and management of large grade varices