Proportion between the segments of the tricuspid valve annulus: anatomic study with human hearts / Determinação da proporção entre os segmentos do anel da valva tricuspide : estudo anatomico em corações de humanos

AUTOR(ES)
DATA DE PUBLICAÇÃO

2006

RESUMO

Objective: The purpose of this study was to determine the proportion among the segments of the human tricuspid valve annulus. Methods: Descriptive autopsy study of 30 human hearts, without fixation, with less than six hours of post-mortem period, without congenital or acquired lesions and without tricuspid regurgitation. The tricuspid valve insufficiency was excluded by infusion of pressured water in the right ventricle with closed pulmonary valve. Digital images of the tricuspid ring on anatomical position and on flattened state were analyzed by specific software. Computerized measurements of the perimeter, septal segment, anteroposterior segment and the linear distance between the anteroseptal and posteroseptal commissures were obtained on anatomical position. Computerized and manual measurements of the perimeter, septal, anterior and posterior segments were obtained on flattened state. The measurements were demonstrated and compared on the two different situations, anatomical position and flattened. The computerized measurements were compared with the manual ones. Results: The mean values of the perimeter, septal and anteroposterior segments of the tricuspid ring, obtained by computerized measurements on anatomical position were: 105mm (±12.7), 30.6mm (±3.7) e 74mm (±9.4), respectively. The mean linear distance between the anteroseptal and posteroseptal commissures was 28.9mm (±3.4). On the flattened state and by computerized measurements, the mean value of the perimeter was 117.5mm (±13.3) and of the septal, anterior e posterior segments were respectively: 32mm (±3.7), 46.3mm (±8.3) e 39.1mm (±8.5). The mean ratio between the antero-posterior and septal segments was 2.43 (±0.212) on the anatomical position and on flattened state was 2.67 (±0.304). Statistical differences were observed in the measurements of perimeter (p<0.0001), septal segment (p=0.003) e antero-posterior segment (p<0.0001) on the two situations. Statistical difference also occurred on the ratios between the antero-posterior and septal segments (p=0.0005). The mean values obtained by manual measurements of the tricuspid ring on flattened state were: 118.5mm (±12.7), 32.6mm (±3.4), 46.6mm (±7.7) e 39.3mm (±7.9), respectively for perimeter, septal, anterior and posterior segments. There weren?t statistical differences on computerized and manual measurements. Conclusions: The proportion between the septal and antero-posterior segments of the normal human tricuspid valve is 1 : 2.43. The attitude of flatting the tricuspid ring to measure the segments, changes their values and the ratios between them

ASSUNTO(S)

valva tricuspide doenças das valvas cardiacas coração heart anatomia heart valve disease cardiac surgical procedures tricuspid valve procedimentos cirurgicos cardiacos anatomy

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