bioskills one the tricuspid and mitral …...the tricuspid and mitral valve comparative anatomy mark...

UW MEDICINE │ TITLE OR EVENT

BIOSKILLS ONE

THE TRICUSPID AND MITRAL VALVE

COMPARATIVE ANATOMY

MARK REISMAN, MD

REISMANM@UW.EDU

Disclosure Statement of Financial Interest

I, Mark Reisman, MD, DO NOT have a

financial interest/arrangement or affiliation

with one or more organizations that could

be perceived as a real or apparent conflict

of interest in the context of the subject of

this presentation.

All TVT 2017 faculty disclosures are listed online and on the app.

AIMS

• Anatomical Differences between the

tricuspid and mitral valve

• Relational anatomy

• Pathology of mitral valve

THE TRICUSPID AND MITRAL VALVE

RELATIONSHIP OF TV TO MV

5

Septal leafletOf tricuspid valve

Coronary sinus

Non coronaryCusp of Aortic Valve

6

LEFT ATRIUM VS RIGHT ATRIUM

THE RIGHT ATRIUM

7

AV Node

MS

S

A

P

CS

Triangle of Koch

Tricuspid ring

THE LEFT ATRIUM

8

11

TV

PV

Ventricular relationship

The mitral valve with theAortic valve backlit

Pulmonaryvalve

RELATIONAL ANATOMY OF THE MITRAL

VALVE

12

RVOTLVOT

LVOT

MITRAL AND TRICUSPID LEAFLETS

14

SA

PCS

THE MTRAL LEAFLETS

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posterior

anterior

SEPARATION OF ANTERIOR AND SEPTAL

LEAFLET OF THE TRICUSPID LEAFLET

16

Optimal location for mitraclip

CHORDAL STRUCTURE OF THE TV AND MV

17

Commissures Defined by the presence of Fan chords

CHORDAE AND PAPILLARY MUSCLES

19

CT directly attached to the septumPM

CT more typicalMV

LMCA

PAPILLARY MUSCLES OF THE TRICUSPID AND MITRAL

VALVES

20

TV

MV

MV

MV

CHORDAL/LEAFLET ATTACHMENTS OF THE

MITRAL VALVE

21

Similar insertions on the tricuspid valve

PATHOLOGY

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MITRAL ANNULAR CALCIFICATION

24

Impact on several TMVR devices

CHORDAL RUPTURE AND LEAFLET

THICKENING OF THE MITRAL LEAFLET

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• Both valves are excellent targets for

percutaneous therapy

• Both valves has unique set of

challenges due to anatomy and

relational anatomy

• I anticipate there will be percutaneous

solutions to the majority of pathologies

affecting both the tricuspid and mitral

valve

CONCLUSION

31