Morphometric Analysis of Annulo - Papillary Distances in Left Ventricle of Human Hearts. -

Objective: Heart dimensions play an important role in heart valve replacement surgeries of the modern era. While fixing of valve during replacement even a minimal difference in the measurements will be crucial for effective postsurgical effective functioning of the valve. There is a marginal difference in the measurements between the attachments of the chordae from the papillary muscle to the valve and the measurements between the papillary muscles to the valve. This study aims to highlight the crucial differences between these measurements which will provide a ready reference for the operating surgeon. Materials & Methods: The left ventricle was studied in 50 human hearts. The distances between the anterior and posterior papillary muscles to the mitral annulus were measured from four fixed points. Results: The mean vertical diameter of the mitral annulus was 16.56mm SD ± 3.27. The mean transverse diameter of the mitral annulus was 18.06 mm SD ± 2.93.Mean measurements from the tip of the anterior papillary muscle to the four fixed points in the annulus were 15.97mm, 17.82 mm, 11.95 mm and16.57 mm. Measurements from the tip of the posterior papillary muscle to the four fixed points in the annulus were 16.20 mm, 13.58 mm, 12.35 mm and 14.97 mm. In cases where the tip of the papillary muscles was bifid, anterior papillary muscle bifidity was 60% and posterior papillary muscle was 30% and 10% in both the papillary muscles. Conclusion: These distances are crucial in heart valve replacement surgeries for maintaining the continuity of the annulo papillary apparatus. This continuity is also done using sutures. Hence a ready reckoner for measurements of the annulo papillary distance will give the operating surgeon a fair idea during prosthetic heart valve replacement surgeries.