Importance of the mitral subvalvular apparatus for left ventricular functional anatomy.

The mitral subvalvular apparatus is so important to attain the integrity of the left ventricular geometric model and systolic pump function of the heart. We conducted a detailed dissection of the anatomic structure of mitral valve complex and left ventricle of 10 adult hearts from fixed human cadavers (eight male and two female) at Department of Anatomy. Faculty of Medicine of Istanbul University and Department of Cardiovascular Surgery, Koşuyolu Heart and Research Hospital. The distribution of chordae tendinea and classification of musculus papillaris were recorded. The distribution of chordae tendinea varied slightly both anterior and posterior groups. Musculus papillaris was not simetrical in all subjects. Four type of musculus papillaris were distinguished. The insertio angulus of musculus papillaris varied between 20 degrees and 55 degrees. The left ventricular distances (inflow-outflow) and axes (short-long) were determined as the criteria, together with the mitral subvalvular apparatus, to gain the architecture of the left ventricle. We believe that the goal a more precise data collection and developed model will influence our understanding of functional anatomy of left ventricular subvalvular apparatus, and concept of changes in left ventricular configuration after mitral valve surgery.