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Morphology and position of the right atrioventricular valve in relation to right atrial structures.
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  • Jakub Holda,
  • Katarzyna Słodowska,
  • Marcin Strona,
  • Małgorzata Mazur,
  • Katarzyna Jasińska,
  • Aleksandra Matuszyk,
  • Mateusz Koziej,
  • Jerzy Walocha,
  • Mateusz Holda
Jakub Holda
Jagiellonian University Medical College
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Katarzyna Słodowska
Jagiellonian University Medical College
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Marcin Strona
Jagiellonian University Medical College
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Małgorzata Mazur
Jagiellonian University Medical College
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Katarzyna Jasińska
Jagiellonian University Medical College
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Aleksandra Matuszyk
Jagiellonian University Medical College
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Mateusz Koziej
Jagiellonian University Medical College
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Jerzy Walocha
Jagiellonian University Medical College
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Mateusz Holda
Jagiellonian University Medical College

Corresponding Author:mkh@onet.eu

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Abstract

Introduction: The aim of this study was to describe the morphology of the right atrioventricular valve (RAV) and determine its spatial position in relation to selected structures of the right atrium. Methods and Results: We examined 200 randomly selected human adult hearts. All leaflets and commissures were identified and measured. The position of the RAV was defined. 3-leaflet configurations were present in 67.0% of cases whereas 4-leaflet configurations were present in 33.0%. Valves with four leaflets have significantly larger perimeter (119.2±11.1 vs. 109.3±11.3mm, p=0.001). No significant difference was found in superior leaflet length and height between 3- and 4-leaflet RAVs. Septal and mural leaflets were both significantly shorter and higher in 4-leaflet than in 3-leaflet RAVs. Significant domination of the muro-septal commissure in 3-leflet valves was noted. The supero-septal commissure was the most stable point within RAV circumference, with no difference in its position between 3- and 4-leaflet valves. In 3-leaflet valves the muro-septal commissure was placed within cavo-tricuspid isthmus area in 52.2% of cases, followed by the right atrial appendage vestibule region (20.9%). In 4-leaflet RAVs, the infero-septal commissure was located predominantly in the cavo-tricuspid isthmus area and infero-mural commissure was always located within the right atrial appendage vestibule region. Conclusions: The RAV is a highly variable structure. The supero-septal part of the RAV is the least variable component, whereas the infero-mural is the most variable. The number of detected RAV leaflets significantly influences the relative position of individual valve components in relation to right atrial structures.