RESUMO
Introduction: Papillary muscles are the conical muscle masses project into the cavity of ventricle and areinserted into the valve cusps by chordae tendinae. They prevent the cusps from being forced back into the atriumduring ventricular contraction. Their number and positions are highly variable. An anomalous papillary musclecan act as an ectopic foci. Hence these variations should be assessed before any operative intervention on thevalve. Present study aim to analyse these variations in detail.Materials and Methods: This is a descriptive observational study to analyse the variations in number andposition of papillary muscles in ventricles of 100 adult human hearts ranging in age from 17 to 80 yearsobtained from autopsy specimens. The methodology used was the dissection method according to standardautopsy techniques. The data obtained were quantified as frequencies (in %).Results: Of the 100 hearts studied, the right ventricle consisted of the usual three groups of papillary muscles in84% of hearts whereas the remaining 16% of hearts had only two groups (rudimentary SPMs). The left ventricleconsisted of two groups of papillary muscles in 73% of hearts ; three groups in 23%; four groups in 4% and noneof the hearts contained single papillary muscle. Regarding the positions, the right ventricle had APMs inanterobasal position, the PPMs in posterobasal position and SPMs was located close to ventricular septum andno extra group of papillary muscles were found. In left ventricle, 73% of hearts had APMs and PPMs in anterolateraland posteromedial positions respectively, whereas in 27% (23% and 4%) hearts, the extra group of papillarymuscles (third group and fourth group) were interlinked to PPMs and was situated in posterolateral position.Conclusion: These findings suggest that the variations in number and positions of papillary muscles should beanticipated before any operative intervention on the valvular apparatus.
RESUMO
Abstracts: Background & Objective: Aim of present study was morphological and morphometric observation of papillary muscles of tricuspid valve of human heart. Methodology: This study was carried out in 36 human (24 males and 12 females) heart from adult cadavers, which were dissected according to standard technique. All papillary muscles were observed for their shapes, numbers and dimensions in centimeters. Data were tabulated and statistical comparison were done using “chi square” and “z” test. Results: The average length of anterior, posterior and septal papillary muscle was 1.42 ± 0.29 cm, 0.94 ± 0.23 cm and 0.18 ± 0.08 cm while average breadth of anterior, posterior and septal papillary muscle was 0.41± 0.12 cm, 0.29± 0.09 cm and 0.11± 0.01 cm respectively. The anterior papillary muscles presented 1 head in 27.78% and 2 heads in 25%, while posterior papillary muscles presented 1 head in 27.78% and 2 heads in 25%. All the septal papillary muscles presented with 1 head. Single anterior papillary muscle was found to be 97.22% while posterior papillary muscle was found to be single in 72.28% and double in 27.78. Septal papillary muscle was found to be single in 25% cases and absent in 38.89% cases. Conclusion: Data obtained from this study might be helpful for reparative surgical procedures of tricuspid valve.
RESUMO
Se realizó un estudio descriptivo de las características anatómicas y biométricas del músculo papilar septal en 30 corazones de individuos adultos chilenos, en edades comprendidas entre 18 y 84 años de edad, de ambos sexos, sin aparente patología cardíaca, pertenecientes a la Unidad de Anatomía Humana Normal del Departamento de Ciencias Básicas de la Universidad de La Frontera. Los resultados mostraron que el músculo papilar septal, se presenta en un 83,3 por ciento de los corazones del estudio. De éstos, el 44,0 por ciento presenta un solo músculo, el 28 por ciento presenta dos músculos y el 28 por ciento tres músculos papilares septales. De los músculos papilares septales encontrados, el 71,1 por ciento correspondió a la forma cono libre, el 24,4 por ciento a la forma cono pegado y el 4,5 por ciento a la forma puente. En cuanto a la longitud de forma cono pegado y cono libre, el rango que se encuentra en mayor porcentaje está entre 4,0 mm 5,99 mm; con un 45,5 por ciento y 42,4 por ciento, respectivamente. Este estudio nos demuestra la importancia de incorporar al músculo papilar septal a la nomenclatura anatómica internacional.
A descriptive research study was carried out on the anatomical and biometric characteristics of the septal papillary muscle in 30 hearts of adult Chilean subjects, between 18 and 84 years of age of both sexes and without apparent cardiac pathology, from the Normal Human Anatomy Unit, Basic Sciences Department of the Universidad de La Frontera. Results show that the septal papillary muscle was present in 83.3 percent of the hearts in the study. Of these 44.0 percent show one muscle only, 28 percent show two muscles and 28 percent show three septal papillary muscles. In the septal papillary muscles found, 71.1 percent are free cone-shaped, 24.4 percent were attached cone-shaped, and 4.5 percent were bridge-shaped. Regarding the length of attached cone and free cone shaped, the highest percentage range was between 4.0 mm and 5.99 mm, with 45.5 percent and 42.4 percent respectively. The present study shows the importance of integrating the septal papillary muscle to the International Anatomical Nomenclature.