The tricuspid valve is not a simple but a complex structure, tricuspid valve complex. This complex is composed of tricuspid orifice, annulus, valve leaflet, chordae tendineae and papillary muscles. There are flew articles about these structures. The authors studied tricuspid valve complex in 53 cases of normal korean adults, such as circumference of tricuspid annulus, the maximum diameter of the tricuspid orifice, height and breadth of the cusps, including commissures, the ratio of rough to clear zone, the number of scallops of posterior cusp, the number, length and pattern of arrangement of the several types of chordae, the number and morphological characteristics of papillary muscles.
Adult* ; Chordae Tendineae ; Heart* ; Humans ; Papillary Muscles ; Pectinidae ; Tricuspid Valve*

The typical radiographic findings of pulmonary edema from the increased hydrostatic pressure shows centrally localized consolidation, which is known as a "butterfly or bat's wing" pattern. These terms describe the anatomic distribution of edema that uniformly involve the hilum and medulla of the lung but not the peripheral region of the lung parenchyma (cortex). We present a case of butterfly wing-like pulmonary edema on a chest radiograph by mitral regurgitation due to an idiopathic chordal rupture.
Butterflies ; Chordae Tendineae ; Edema ; Hydrostatic Pressure ; Lung ; Mitral Valve Insufficiency ; Pulmonary Edema* ; Radiography, Thoracic ; Rupture*

Post-traumatic tricuspid insufficiency is a rare condition and may be clinically silent and imprecise. The diagnosis may be difficult when it progreses slowly and other acute lesions exist concomittantly. Two-dimenstional Doppler echocardiography appears to be an essential procedure in diagnosting the rupture of chordae tendineae or papillary muscle following traumatic injury. We report a case of tricuspid insufficiency of which symptom developed 8 years later following a blunt chest trauma. The patient was operated by tricuspid vlave repair with chordal replacement and ring annuloplasty successfully. We would like to emphasize that patients sustaining major thoracic trauma should be carefully examine for possible blunt chest trauma including cardiac valve rupture or tear.
Chordae Tendineae ; Diagnosis ; Echocardiography, Doppler ; Heart Valves ; Humans ; Papillary Muscles ; Rupture ; Thorax*

Child ; Chordae Tendineae ; injuries ; Female ; Heart Valve Diseases ; diagnosis ; surgery ; Humans ; Mitral Valve ; injuries

Chordae Tendineae ; Female ; Heart Rupture ; Humans ; Mitral Valve Insufficiency ; Pre-Eclampsia ; Pregnancy ; Rupture

The mitral valve complex is consisted of annulus, leaflets, chordae tendineae, papillary muscle (PMs) and surrounding left ventricle. Functional mitral regurgitation (MR) results from left ventricular remodeling such as dilatation or distortion, which displaces the PMs and then tethers the mitral leaflets, restricting leaflet coaptation. Undersized annuloplasty, which has been widely accepted as a simple and effective procedure for functional MR, sometimes worsens the tethering of posterior leaflet and induces recurrent MR. In order to overcome such problems, several additional procedures to the simple annuloplasty have been produced. Three dimensional echocardiography plays an essential role to understand the geometry of mitral valve complex and contributes greatly to decision making of the surgical strategy in functional MR and its postoperative assessment.
Chordae Tendineae ; Decision Making ; Dilatation ; Echocardiography, Three-Dimensional ; Heart Ventricles ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles ; Ventricular Remodeling

The incidence and importance of tricuspid valve regurgitation after a blunt chest injury has risen with the increase in the number of automobile accidents and steering wheel traumas. This kind of injury has been reported more frequently in the last decade because of the better diagnostic procedures and understanding of the pathology. However, tricuspid valve regurgitation following a blunt chest injury can still be easily missed because most patients do not show symptoms at the time of the trauma. A 55-year-old male patient presented himself at our facility after suffering a chest injury from an automobile accident. His transthoracic echocardiography (TTE) revealed severe tricuspid valve regurgitation due to the prolapse of his anterior valve leaflet. We report a case of asymptomatic tricuspid regurgitation that developed after a blunt chest injury.
Automobiles ; Chordae Tendineae* ; Echocardiography ; Humans ; Incidence ; Male ; Middle Aged ; Pathology ; Prolapse ; Rupture* ; Thoracic Injuries* ; Thorax* ; Tricuspid Valve Insufficiency* ; Wounds, Nonpenetrating

We report a successful repair of severe traumatic tricuspid regurgitation by PTFE chordal replacement and ring annuloplasty. A 64-year-old man with multiple trauma was referred to our department because of cardio- megaly on chest roentgenogram. Echocardiography showed moderate amount of pericardial effusion and severe tricuspid regurgitation with rupture of anterior papillary muscle. But he experienced progressive dyspnea, and chest roentgenogram showed progressive cardiomegaly. He underwent operation 4 months after trauma. The nterior papillary muscle was reinserted, and the valve was repaired by PTFE chordal replacements and ring annuloplasty. Postoperatively, the patient's functional status was improved, and there was trivial tricuspid regurgitation on echocardiographic examination.
Cardiomegaly ; Chordae Tendineae ; Dyspnea ; Echocardiography ; Humans ; Middle Aged ; Multiple Trauma ; Papillary Muscles ; Pericardial Effusion ; Polytetrafluoroethylene* ; Rupture ; Thorax* ; Tricuspid Valve Insufficiency*

BACKGROUND AND OBJECTIVES: The proportion of mitral regurgitation caused by chordae rupture has recently been seen to be increasing, as has the role of mitral valve repair in the treatment of chordae rupture. This study evaluated the clinical characteristics and trends of surgical treatment of chordae rupture. Additionally, we attempted to discern the usefulness of transthoracic echocardiography (TTE) in the preoperative diagnosis of chordae rupture. SUBJECTS AND METHODS: Forty patients (20 men, mean age:49+/-14) presenting with chordae rupture confirmed during surgery between January 1994 and April 2001 were included in this study. Clinical, TTE and surgical data were analyzed retrospectively. RESULTS: The cause of chordae rupture was idiopathic degeneration in 28 cases, rheumatic heart disease in 5, infective endocarditis in 6, and trauma in 1 case. The sites of rupture were the anterior leaflet (14), posterior leaflet (23), and anterior and posterior leaflets (3). Mitral valve repair was performed in 20 cases and mitral valve replacement was performed in 20 cases. Most mitral valve repairs were performed beginning in 1998 (17/20). Chordae rupture diagnosed by TTE numbered 14 cases (35%). CONCLUSION: Regurgitation caused by chordae rupture was primarily associated with idiopathic degenerative change. Posterior leaflet rupture was more frequent than anterior leaflet rupture. The use of mitral valve repair has been increasing since 1998.
Chordae Tendineae ; Diagnosis ; Echocardiography ; Endocarditis ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Retrospective Studies ; Rheumatic Heart Disease ; Rupture*

A 69-year-old male presented with obstructive hypertrophic cardiomyopathy, mitral valve regurgitation, and myxomatous mitral valve prolapse. A spontaneous chordal rupture and acute severe mitral regurgitation resulted in abrupt clinical deterioration despite complete relief of severe left ventricular outflow tract obstruction and systolic anterior motion of the anterior mitral leaflet. The patient underwent extensive cardiac surgery due to intractable heart failure. Surgical procedures included a mitral valve replacement, a septal myectomy, and the Maze procedure.
Aged ; Cardiomyopathy, Hypertrophic ; Chordae Tendineae ; Heart Failure ; Humans ; Male ; Mitral Valve ; Mitral Valve Insufficiency ; Mitral Valve Prolapse ; Rupture ; Thoracic Surgery