The study of cardiac valve annular dimensions and their clinical significance

Hannah Sugirthabai Rajila, R (2007) The study of cardiac valve annular dimensions and their clinical significance. Masters thesis, Stanley Medical College, Chennai.


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AIM OF THE STUDY: Cardiac valves are affected both by congenital malformations and by acquired valvular diseases. Disease can cause either a stenotic or a regurgitant lesion. In the former condition there is a narrowing of the orifice but the annulus remains normal , whereas in the later the vale annulus is widened. So to replace the valve and to know the severity of the regurgitant lesion the normal valve size should be known. When a valve is being replaced, it can result in a condition called patient –prosthesis mismatch. This can result in restrictive changes of the heart due to the prosthetic valve being smaller than the annular size of the valve. Similarly in mitral valve lesion, left ventricular size changes. To know the impact of valvular lesion to left ventricular size and function, the normal correlation between the two should be known. Hence, the annuli of cardiac values are used as the size index for prosthetic valves, to diagnose and categorize the severity of regurgitant lesions and to know impact of the left ventricular size variations on the mitral valve diameter. MATERIALS AND METHODS: The study was conducted on live patients who visited the cardiology out patient department at Stanley Medical College, Chennai. All the subjects were healthy and were at cardiology out patient department for regular check up. The total number of subjects were four hundred and six, out of which two hundred and fifty two were males and one hundred and fifty four were females. The male female ratio in this study is given here as it is not an observation but a prelude and an essential part of this study. The differences found in the dimensions of cardiac valves with respect to the age and sex factors are tabulated and assessed in the observations chapter. They were still further classified according to their ages. Twenty two were less than five years range (out of which 13 were males and 40 were females) and forty were in the range of six to ten years (20 each in male and female category). METHODS: The study was conducted on all 406 subjects by means of echocardiogram. The dimensions of annuli of mitral, tricuspid, pulmonary and aortic valves were measured by two dimensional echocardiogram, which is an instrument used to create an image using a transducer which sends ultrasound waves. The transducer converts the returning echoes to electrical impulses, which then go to the receiver and the signal amplifier and are displayed on the cathode ray tube. OBSERVATIONS: The dimensions of mitral, tricuspid, pulmonary and aortic valves were recorded using two dimensional echocardiogram. Total number of subjects was four hundred and six. The distribution of males ands females are given in the materials and methods chapter. Each valve was studied according to the views specified in materials and methods. The diameters was recorded for all four valves in millimeters. From this data, the circumference and area was deduced. The diameters of mitral, tricuspid, aortic and pulmonary valves were tabulated against body surface area. Age, sex, height and weight of the subjects were recorded simultaneously. The diameters were again plotted against the age of the subjects dividing them into five year categories. The area was calculated and was tabulated against males and females. The recorded and weight data helped in the calculation of body surface area and body mass index of the subjects. SUMMARY: This study on the cardiac valve annular dimensions and their clinical significance has shown that: • All the four cardiac valve dimensions increased as the body surface area increased. • The diameter of the mitral valve is significantly smaller in the study population. • The diameter of the tricuspid valve is also smaller, but requires to be studied further. • The diameters of the aortic and pulmonary valves are within normal values. • With increasing age the cardiac valves also increased in size upto the age of twenty. • The cardiac valve areas were definitely more in males when compared to females. • All the four cardiac valve dimensions showed a linear increase with body mass index, proving height and weight to be the principal determinants of their dimensions. • Mitral valve diameter increased with increase in the left ventricular size.

Item Type: Thesis (Masters)
Uncontrolled Keywords: cardiac valve annular dimensions, clinical significance.
Subjects: MEDICAL > Anatomy
Depositing User: Subramani R
Date Deposited: 05 Oct 2019 03:53
Last Modified: 05 Oct 2019 03:53

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