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 Table of Contents  
ORIGINAL ARTICLE
Year : 2017  |  Volume : 10  |  Issue : 3  |  Page : 314-316

A cadaveric study: “Measurements of tricuspid valve using cardiac sizer in the North Karnataka Region”


Department of Anatomy, KLE University's J. N. Medical College, Belagavi, Karnataka, India

Date of Web Publication5-Sep-2017

Correspondence Address:
Supriya Premkumar
Department of Anatomy, KLE University's J. N. Medical College, Belagavi, Karnataka
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijhs.ijhs_78_17

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  Abstract 


Background: The right atrioventricular orifice is guarded by a complex called as tricuspid valve complex. The complex consists of atrioventricular orifice, annulus, leaflets, chordae tendineae, and papillary muscles. The right atrioventricular orifice passes the blood to the right ventricle in one-way direction, and this orifice is guarded by valve called as tricuspid valve. Tricuspid valve prevents the back flow of blood into the right atrium.
Materials and Methods: This study was done on thirty human cadavers, which included 15 male and 15 female cadavers belonging to age group ranging from 50 to 70 years. Diameter of tricuspid valve was recorded using cardiac sizer and circumference of tricuspid valve was calculated by formula c = πd.
Results: The average diameter of tricuspid valve in males was 26.06 ± 2.49 mm and in females was 24.33 ± 1.75 mm. The average circumference of tricuspid valve in males was 80.8 ± 7.72 mm and in females was 75.4 ± 5.45 mm.
Conclusion: Clinically, during the replacement surgery of the tricuspid valve, surgeons are in need of actual circumference and diameter of tricuspid valve. Hence, the main objectives of this study are to measure the diameter and circumference of the tricuspid valve which will be helpful for cardiac surgeons, invasive cardiologists, and for preparation of synthetic (prosthetics) valve.

Keywords: Cadaver, circumference, diameter, parameter, tricuspid valve


How to cite this article:
Premkumar S, Desai SP, Virupaxi R D. A cadaveric study: “Measurements of tricuspid valve using cardiac sizer in the North Karnataka Region”. Indian J Health Sci Biomed Res 2017;10:314-6

How to cite this URL:
Premkumar S, Desai SP, Virupaxi R D. A cadaveric study: “Measurements of tricuspid valve using cardiac sizer in the North Karnataka Region”. Indian J Health Sci Biomed Res [serial online] 2017 [cited 2019 Jun 17];10:314-6. Available from: http://www.ijournalhs.org/text.asp?2017/10/3/314/214011




  Introduction Top


Heart is a fibromuscular, conical hollow organ covered by the pericardium and located in middle mediastinum. Heart is having four chambers both right and left atria and ventricles. Right atrium communicates with right ventricle through the tricuspid valve and left atrium communicates with left ventricle through the mitral valve. The right atrioventricular orifice is guarded by a complex called as tricuspid valve complex. The complex consists of atrioventricular orifice, annulus, leaflets, chordae tendineae, and papillary muscles.[1]

The right atrioventricular orifice passes the blood to the right ventricle in one-way direction, and this orifice is guarded by valve called as tricuspid valve. Tricuspid valve prevents the backflow of blood into the right atrium.[2]


  Materials and Methods Top


This study was done on thirty human cadavers, which included 15 male and 15 female cadavers belonging to age group ranging from 50 to 70 years.

The following parameters were recorded:

  1. Diameter of tricuspid valve


    • Diameter was recorded using cardiac sizer [Figure 1].
    Figure 1: Method of measuring diameter of tricuspid valve

    Click here to view


  2. Circumference of tricuspid valve


    • Circumference was calculated by formula c = πd



  Results Top


It was observed that the diameter and circumference were greater in males when compared to those of females. In both sexes, circumference was larger than the diameter of tricuspid valve, which was statistically significant. The average diameter of tricuspid valve in males was 26.06 ± 2.49 mm and 24.33 ± 1.75 mm in females, and the average circumference of tricuspid valve in males was 80.8 ± 7.72 mm and 75.4 ± 5.45 mm in females [Table 1].
Table 1: Results showing the mean parameters of tricuspid valve in males and females

Click here to view



  Discussion Top


In Indian population, few studies on tricuspid valve are available. The dimensions obtained from the autopsy data of normal tricuspid valve can be baseline data for cardiac surgeons.[3]

The cadaveric study of tricuspid valve in different regions will help to determine the regional variations of tricuspid valve and will help to construct the suitable prostheses for the given population.

In the present study, the diameter of tricuspid valve was 26.06 ± 2.49 mm in males and 24.33 ± 1.75 mm in females. The values obtained for males and females in Western countries that is studies done by Westaby et al.,[4] Birmingham, Seccombe et al.,[5] Minnesota, and Dwivedi et al.,[6] the UK, were greater than the present study done in North Karnataka, India. Hence, it indicates that the values are different in different countries, which shows the regional variations [Table 2].
Table 2: Comparative study of mean tricuspid valve diameter in different regions in males and females

Click here to view


From the above study, it is concluded that the tricuspid valve diameter is more in males than in females.

In the present study, the circumference of tricuspid valve was 80.0 ± 7.72 mm in males and 75.4 ± 5.45 mm in females. The values obtained for males and females in Western countries that is studies done by Silver et al.,[7] Canada, Westaby et al.,[4] Birmingham, Kocak et al.,[8] Turkey, were greater than the present study done in North Karnataka, India. Hence, it indicates that the values are different in different countries, which shows the regional variations.

In India, when compared South Karnataka with North Karnataka, the study done by Kalyani et al.,[3] Kolar (South) Karnataka, shows that the circumference of tricuspid valve in males and females is greater than the present study done at North Karnataka.

From the above study, it is concluded that the circumference of tricuspid valve is more in males than in females [Table 3].
Table 3: Comparative study of mean tricuspid valve circumference in different regions in males and females

Click here to view


A comparative study between Westaby et al., Birmingham and the present study done in North Karnataka (India) among the two parameters

The study done by Westaby et al.[4] conducted a study on adult human valve dimensions and their surgical significance, from the autopsy records of the specialized center for research in ischemic heart disease at the University of Alabama in Birmingham. They selected 160 human adult hearts. There were 49 women and 111 men and their ages ranged from 16 to 83 years. Patients with primary valve diseases were excluded from the study. Sixteen out of 49 women and 47 out of 111 men had congestive cardiac failure. Soon after the death of the patients, the hearts were obtained and fixed with 10% of formalin and were examined. The circumference of the tricuspid valve was measured by opening the valve ring, laying it flat, and measuring to the nearest millimeter with a ruler. The circumference of tricuspid valve was then used to calculate diameter. They found the dimensions of the tricuspid valve in patients without congestive heart failure and found that the tricuspid valve diameter for males was 38.0 ± 4.0 mm and females was 33.2 ± 3.3 mm and overall diameter was 36.4 ± 4.4 mm. The circumference for males was 11.95 ± 1.26 cm (119.5 ± 12.6 mm) and for females was 10.40 ± 1.06 cm (104 ± 10.6 mm) and overall circumference was 11.63 ± 1.39 cm (116.3 ± 13.9 mm). They also found the dimensions of the tricuspid valve in patients with congestive heart failure and found that the tricuspid valve diameter for males was 39.7 ± 4.6 mm and females was 36.4 ± 3.6 mm and overall diameter was 38.9 ± 4.6 mm. The circumference for males was 12.48 ± 1.44 cm and for females was 11.46 ± 1.14 cm and overall circumference was 12.22 ± 1.43 cm.[4]

In the present study done in North Karnataka, the mean diameter of tricuspid valve was 26.06 ± 2.49 mm in males and 24.33 ± 1.75 mm in females and the mean circumference of tricuspid valve was 80.0 ± 7.72 mm in males and 75.4 ± 5.45 mm in females [Table 4].
Table 4: Comparative study of mean values of parameters among Western region and India

Click here to view


From the above data, it is concluded that the mean diameter and circumference of tricuspid valve in males and females in the Western world are greater than the present study done in North Karnataka, India. Hence, it indicates that the values are different in different countries, which shows the regional variations.


  Conclusion Top


Clinically, during the replacement surgery of the tricuspid valve, surgeons are in need of actual circumference and diameter of tricuspid valve. Hence, the main objectives of this study are to measure the diameter and circumference of the tricuspid valve which will be helpful for cardiac surgeons, invasive cardiologists, and for preparation of synthetic (prosthetics) valve.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Datta AK. The Heart, Essentials of Human Anatomy (Thorax and Abdomen). 9th ed. Kolkata: Current Book International; 2013. p. 61-9.  Back to cited text no. 1
    
2.
Garg K. Pericardium and heart. BD Chaurasia's Human Anatomy Regional and Applied Dissection and Clinical (Upper limb Thorax). 6th ed. New Delhi: CBS Publishers and Distributers; 2012. p. 255.  Back to cited text no. 2
    
3.
Kalyani R, Thej MJ, Prabhakar K, Venkatesh TK, Thomas AK, Kiran J. Morphometric analysis of tricuspid valve: An Indian perspective. J Nat Sci Biol Med 2012;3:147-51.  Back to cited text no. 3
[PUBMED]    
4.
Westaby S, Karp RB, Blackstone EH, Bishop SP. Adult human valve dimensions and their surgical significance. Am J Cardiol 1984;53:552-6.  Back to cited text no. 4
[PUBMED]    
5.
Seccombe JF, Cahill DR, Edwards WD. Quantitative morphology of the normal human tricuspid valve: Autopsy study of 24 cases. Clin Anat 1993;6:203-12.  Back to cited text no. 5
    
6.
Dwivedi G, Mahadevan G, Jimenez D, Frenneaux M, Steeds RP. Reference values for mitral and tricuspid annular dimensions using two-dimensional echocardiography. Echo Res Pract 2014;1:43-50.  Back to cited text no. 6
[PUBMED]    
7.
Silver MD, Lam JH, Ranganathan N, Wigle ED. Morphology of the human tricuspid valve. Circulation 1971;43:333-48.  Back to cited text no. 7
[PUBMED]    
8.
Kocak A, Govsa F, Aktas EO, Boydak B, Yavuz IC. Structure of the human tricuspid valve leaflets and its chordae tendineae in unexpected death. A forensic autopsy study of 400 cases. Saudi Med J 2004;25:1051-9.  Back to cited text no. 8
[PUBMED]    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2], [Table 3], [Table 4]



 

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