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pertains to excessive leaflet motion leading to leaflet prolapse. Common causes include, but is not limited to, Barlow disease, myxomatous degeneration, inflammation, and papillary muscle rupture. Type III pertains to restrictive motion of the leaflets. Type IIIa pertains to restrictive motion during systole and diastole. Type IIIb pertains to restrictive motion during systole.
328:. The anterior cusp attaches to one third of the circumverence of the annulus, and the posterior cusp attaches to the remaining two thirds of its circumference. Occasionally, the anterior and posterior cusps close the orifice incompletely and a small additional accessory cusp is present to fill the interval. The anterior cusp is thicker and more rigid than the posterior one,
65:
1528:
Document
Committee of the European Association of Cardiovascular Imaging, Multi-modality imaging assessment of native valvular regurgitation: an EACVI and ESC council of valvular heart disease position paper, European Heart Journal - Cardiovascular Imaging, Volume 23, Issue 5, May 2022, Pages e171–e232,
652:
Mitral disease can be classified using
Carpentier's classification which is based on the leaflet motion. Type I pertains to normal leaflet motion. Whereas, disease of the valve is categorized to primary mitral regurgitation or secondary mitral regurgitation based on the regurgitant etiology. Type II
429:
The normal diameter of the mitral annulus is 2.7 to 3.5 centimetres (1.1 to 1.4 in), and the circumference is 8 to 9 centimetres (3.1 to 3.5 in). Microscopically, there is no evidence of an annular structure anteriorly, where the mitral valve leaflet is contiguous with the posterior aortic
349:
In
Carpentier's classification of a mitral valve, both the posterior and anterior mitral valve leaflets are divided into eight segments: P3 (medial scallop), P2 (middle scallop), P1 (lateral scallop), A3 (anteromedial segment), A2 (anteromedial), A1 (anterolateral), PMC (posteromedial commissure),
1527:
Patrizio
Lancellotti, Philippe Pibarot, John Chambers, Giovanni La Canna, Mauro Pepi, Raluca Dulgheru, Mark Dweck, Victoria Delgado, Madalina Garbi, Mani A Vannan, David Montaigne, Luigi Badano, Pal Maurovich-Horvat, Gianluca Pontone, Alec Vahanian, Erwan Donal, Bernard Cosyns, the Scientific
588:
bundles in the fibrosa. This weakens the cusps and adjacent tissue, resulting in an increased cuspal area and lengthening of the chordae tendineae. Elongation of the chordae tendineae often causes rupture, commonly to the chordae attached to the posterior cusp. Advanced lesions—also commonly
393:
to the left atrium). Each chord has a different thickness. The thinnest ones are attached to the free leaflet margin, whereas the thickest ones (strut chords) are attached further from the free margin. This disposition has important effects on systolic stress distribution physiology.
459:
of the left ventricle. This early filling phase is due to active relaxation of the ventricular myocardium, causing a pressure gradient that allows a rapid flow of blood from the left atrium, across the mitral valve. This early filling across the mitral valve is seen on doppler
743:
258:
with contraction of the left ventricle. The valve opens and closes because of pressure differences, opening when there is greater pressure in the left atrium than ventricle and closing when there is greater pressure in the left ventricle than atrium.
618:
and so has chordae originating on both sides of the ventricular septum. Mitral valve agenesis is very rare, defined as an absence or minimal presence of both mitral valve leaflets (complete agenesis) or one of the leaflets (partial agenesis).
478:) (during left ventricular diastole) causes added blood to flow across the mitral valve immediately before left ventricular systole. This late flow across the open mitral valve is seen on doppler echocardiography of the mitral valve as the
539:
501:. This reduction in annulus size at the end of atrial systole may be important for the proper coapting of the leaflets of the mitral valve when the left ventricle contracts and pumps blood. Leaking valves can be corrected by
613:
occurs when all chordae tendineae of the mitral valve are abnormally attached to a single (or fused) papillary muscle. Straddling Mitral Valve occurs when the mitral valve's chordal attachments straddles, or goes through, a
1158:
Lancellotti, P.; Moura, L.; Pierard, L. A.; Agricola, E.; Popescu, B. A.; Tribouilloy, C.; Hagendorff, A.; Monin, J. L.; Badano, L.; Zamorano, J. L.; on behalf of the
European Association of Echocardiography (2010-05-01).
388:
When the left ventricle contracts, the pressure in the ventricle forces the valve to close, while the tendons keep the leaflets coapting together and prevent the valve from opening in the wrong direction (thus preventing
320:
The mitral valve is typically 4 to 6 square centimetres (0.62 to 0.93 sq in) in area and sits in the left heart between the left atrium and the left ventricle. It has two cusps: an anterior one, and a posterior
669:. It is not the valve closure itself which produces the sound but the sudden cessation of blood flow, when the mitral and tricuspid valves close.. Abnormalities associated with the mitral valve can often be heard when
540:
731:
547:
Heart sounds of a 16 year old girl diagnosed with mitral valve prolapse and mitral regurgitation. Auscultating her heart, a systolic murmur and click is heard. Recorded with the stethoscope over the mitral
362:
The left side of the heart. The mitral valve, as well as the chordae tendinae are visible as white strings. These connect to the papillary muscles visible attaching to the muscular ventricle.
538:
1239:
Mahmood, Feroze; Shakil, Omair; Mahmood, Bilal; Chaudhry, Maria; Matyal, Robina; Khabbaz, Kamal R. (December 2013). "Mitral
Annulus: An Intraoperative Echocardiographic Perspective".
972:. Kasper, Dennis L.,, Fauci, Anthony S., 1940-, Hauser, Stephen L.,, Longo, Dan L. (Dan Louis), 1949-, Jameson, J. Larry,, Loscalzo, Joseph (19th ed.). New York. 2015-04-08.
497:
The mitral annulus changes in shape and size during the cardiac cycle. It is smaller at the end of atrial systole due to the contraction of the left atrium around it, like a
455:, the mitral valve opens, and blood travels from the left atrium to the left ventricle. About 70 to 80% of the blood that travels across the mitral valve occurs during the
1161:"European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease)"
1481:"Mitral annulus caseous calcification mimicking cardiac mass in asymptomatic patient – multimodality imaging approach to incidental echocardiographic finding"
150:
1347:
422:
to help provide complete closure of the leaflets. Expansion of the annulus can result in leaflets that do not join soundly together, leading to functional
482:. The late filling of the left ventricle contributes about 20% to the volume in the left ventricle prior to ventricular systole and is known as the
541:
1389:
1001:
922:
875:
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in the left ventricle, and at the other to the valve cusps. Papillary muscles are finger-like projections from the wall of the left ventricle.
1582:
1565:
126:
1210:"Patterns of systolic stress distribution on mitral valve anterior leaflet chordal apparatus. A structural mechanical theoretical analysis"
2000:
48:
609:
There are also some rarer forms of congenital mitral valve disease that are often associated with other congenital heart anomalies.
334:
Although the anterior leaflet takes up a larger part of the ring and rises higher, the posterior leaflet has a larger surface area.
1021:"Interaction between mitral valve apparatus and left ventricle. Functional mitral regurgitation: A brief state-of-the-art overview"
49:
1615:
50:
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57:
Anterior (frontal) view of the opened heart. White arrows indicate normal blood flow. (Mitral valve labeled at center right.)
51:
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and covers approximately two-thirds of the valve. The anterior cusp intervenes between the mitral and aortic orifices.
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ALC (anterolateral commissure). Mitral leaflet thickness is usually about 1 mm but sometimes can range from 3–5 mm.
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1367:
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44:
42:
41:
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is a narrowing of the valve. This can be heard as an opening snap; a heart sound which is not normally present.
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involving the posterior leaflet—lead to leaflet folding, inversion, and displacement toward the left atrium.
145:
642:
2078:
1855:
1608:
390:
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The human heart, viewed from the front. The mitral valve is visible on the right as the "bicuspid valve"
1005:
1879:
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342:
109:
1859:
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414:, it is not continuous. The mitral annulus is saddle shaped and changes in shape throughout the
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610:
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566:
411:
407:
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596:, which is the regurgitation or backflow of blood due to the incomplete closure of the valve.
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2020:
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20:
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2015:
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Operative view of the mitral valve with a chordal rupture "fail" of the anterior leaflet
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The valve leaflets are prevented from prolapsing into the left atrium by the action of
358:
451:, after the pressure drops in the left ventricle due to relaxation of the ventricular
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2005:
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2010:
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570:
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114:
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505:, a common surgical procedure that aims at restoring proper leaflet adjustment.
1992:
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The opening of the mitral valve is surrounded by a fibrous ring known as the
236:
138:
1585:
at Human
Anatomy Online, SUNY Downstate Medical Center—"Valves of the heart"
1292:
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1941:
1937:
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778:
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439:
1301:
680:, which can reveal the size, anatomy and flow of blood through the valve.
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1982:
1974:
1921:
1825:
1815:
1762:
716:
710:
666:
315:
216:
1529:
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The closing of the mitral valve and the tricuspid valve constitutes the
254:
with contraction of the left atrium, and the mitral valve closes during
2090:
1905:
1593:
1430:
Séguéla, Pierre-Emmanuel; Houyel, Lucile; Acar, Philippe (2011-08-01).
557:
452:
1348:"Effect of atrial fibrillation on the dynamics of mitral annular area"
471:
After the E wave, there is a period of slow filling of the ventricle.
250:
In normal conditions, blood flows through an open mitral valve during
163:
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239:
allowing blood flow in just one direction. The mitral valve and the
646:
635:
585:
448:
262:
In abnormal conditions, blood may flow backward through the valve (
251:
1589:
Cardiac Valve
Animations—Perioperative Interactive Education Group
1276:"The Mitral Apparatus: Functional Anatomy of Mitral Regurgitation"
602:
often affects the mitral valve. The valve may also be affected by
489:
798:
255:
1318:
Valvular Heart
Disease: A Companion to Braunwald's Heart Disease
938:
PORTH'S PATHOPHYSIOLOGY : concepts of altered health states
720:, meaning "point", reflecting the dual-flap shape of the valve.
16:
Valve in the heart connecting the left atrium and left ventricle
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that thickens the spongiosa layer of the cusp and separates
418:. The annulus contracts and reduces its surface area during
750:
190:
64:
1101:
Omran, A. S.; Arifi, A. A.; Mohamed, A. A. (2010-07-01).
844:
Gray's
Anatomy: The Anatomical Basis of Clinical Practice
310:
3D medical animation still shot of mitral valve prolapse
247:
because they lie between the atria and the ventricles.
1345:
410:
that is attached to the mitral valve leaflets. Unlike
676:
The mitral valve is often also investigated using an
1545:
Ingels, Neil B.; Karlsson, Matts (21 January 2016).
1315:
Otto, Catherine M.; Bonow, Robert (September 2009).
1208:
Nazari S, Carli F, Salvi S, et al. (Apr 2000).
196:
193:
73:. (Bicuspid (mitral) valve visible at bottom left.
274:often affects the mitral valve; the valve may also
187:
184:
1077:(12th ed.). Elsevier Australia. p. 201.
1429:
1241:Journal of Cardiothoracic and Vascular Anesthesia
1100:
935:
645:that can be mistaken for an intracardiac mass or
2140:
1207:
891:Guyton and Hall's Textbook of medical physiology
38:
23:, a congenital abnormality of the aortic valve.
1544:
1432:"Congenital malformations of the mitral valve"
1390:"Mitral valve prolapse: time for a fresh look"
1387:
1273:
1025:Advances in Clinical and Experimental Medicine
1609:
69:Base of ventricles exposed by removal of the
1616:
1602:
1346:Pai RG, Varadarajan P, Tanimoto M (2003).
1072:
1018:
1000:: CS1 maint: location missing publisher (
970:Harrison's principles of internal medicine
921:: CS1 maint: location missing publisher (
888:
874:: CS1 maint: location missing publisher (
63:
1554:. Linköping University Electronic Press.
1504:
1447:
1381:
1314:
1291:
1176:
1134:
1036:
889:Guyton, Arthur C.; Hall, John E. (2011).
841:
643:calcification of the mitral valve annulus
1623:
1388:Playford, David; Weyman, Arthur (2001).
749:The chest, showing surface relations of
508:
488:
365:
357:
341:
305:
297:
1339:
1274:Perloff, J. K.; Roberts, W. C. (1972).
266:) or the mitral valve may be narrowed (
2141:
1876:moderator band/septomarginal trabecula
1478:
1107:Journal of the Saudi Heart Association
1103:"Echocardiography of the mitral valve"
1068:
1066:
1064:
893:(Twelfth ed.). Philadelphia, Pa.
377:. The chordae tendineae are inelastic
282:. The mitral valve is named after the
1597:
1530:https://doi.org/10.1093/ehjci/jeab253
801:specimen from within the left atrium.
641:Rarely there can be a severe form of
1165:European Journal of Echocardiography
1096:
1094:
1012:
714:, from Latin, meaning "double", and
630:. A less invasive method is that of
353:
1436:Archives of Cardiovascular Diseases
1061:
1019:Donal, E; Panis, V (October 2021).
13:
1538:
1394:Reviews in Cardiovascular Medicine
1352:The Journal of Heart Valve Disease
520:
99:valva atrioventricularis sinistra,
34:
14:
2165:
1576:
1571:from the original on 19 May 2022.
1091:
790:
742:
730:
665:(S1), which can be heard with a
656:
556:Problems playing this file? See
536:
180:
1521:
1472:
1423:
1308:
1267:
1232:
616:ventricular septal defect (VSD)
592:A valve prolapse can result in
1201:
1151:
1073:Sinnatamby, Chummy S. (2011).
962:
929:
882:
842:Standring, Susan, ed. (2016).
835:
569:that affect the mitral valve.
223:or flaps and lies between the
1:
828:
638:to open up a stenotic valve.
290:, which resembles its flaps.
683:
671:listening with a stethoscope
622:Surgery can be performed to
532:Mitral Valve Prolapse murmur
325:
293:
278:with age and be affected by
7:
2079:sternopericardial ligaments
1856:valve of inferior vena cava
1485:Polish Journal of Radiology
1479:Kosior, Dariusz A. (2014).
940:. : WOLTERS KLUWER HEALTH.
806:
700:" (bishop's hat). The word
464:of the mitral valve as the
433:
337:
235:. The heart valves are all
213:left atrioventricular valve
10:
2170:
1677:posterior interventricular
1449:10.1016/j.acvd.2011.06.004
1253:10.1053/j.jvca.2013.02.008
1214:J Cardiovasc Surg (Torino)
1119:10.1016/j.jsha.2010.04.001
936:NORRIS, TOMMIE L. (2018).
797:Mitral valve, viewed in a
723:
580:is caused by an excess of
513:
437:
397:
313:
19:Not to be confused with a
18:
2110:
2091:epicardium/visceral layer
2064:
2046:
1991:
1973:
1966:
1904:
1880:crista supraventricularis
1814:
1807:
1781:
1709:
1702:
1672:anterior interventricular
1639:
1632:
1178:10.1093/ejechocard/jeq031
696:, meaning "shaped like a
503:mitral valve annuloplasty
474:Left atrial contraction (
156:
144:
132:
120:
108:
92:
87:
82:
77:visible at bottom right.)
62:
33:
28:
1583:Anatomy figure: 20:07-03
1323:Elsevier Health Sciences
1860:valve of coronary sinus
1773:atrioventricular septum
1741:interventricular septum
1293:10.1161/01.cir.46.2.227
600:Rheumatic heart disease
567:valvular heart diseases
381:attached at one end to
272:Rheumatic heart disease
245:atrioventricular valves
2098:fold of left vena cava
1848:limbus of fossa ovalis
1548:Mitral Valve Mechanics
628:repair a damaged valve
611:Parachute mitral valve
604:infective endocarditis
525:
494:
370:
363:
346:
311:
303:
280:infective endocarditis
158:Anatomical terminology
54:
1894:pulmonary circulation
1004:) CS1 maint: others (
634:which uses a balloon
578:mitral valve prolapse
524:
509:Clinical significance
492:
369:
361:
345:
309:
301:
215:, is one of the four
207:), also known as the
53:
21:bicuspid aortic valve
2123:Coronary circulation
1952:systemic circulation
1791:intervenous tubercle
1038:10.17219/acem/143324
632:mitral valvuloplasty
594:mitral insufficiency
424:mitral regurgitation
264:mitral regurgitation
103:valvula bicuspidalis
2074:fibrous pericardium
1497:10.12659/PJR.889830
823:Electrocardiography
476:left atrial systole
457:early filling phase
2118:Circulatory system
2086:serous pericardium
2048:Pericardial cavity
1746:trabeculae carneae
1719:interatrial septum
769:are labeled with "
526:
495:
391:blood flowing back
371:
364:
347:
312:
304:
55:
2136:
2135:
2128:Coronary arteries
2106:
2105:
2056:pericardial sinus
2016:Bachmann's bundle
2006:cardiac pacemaker
2001:Conduction system
1962:
1961:
1852:crista terminalis
1803:
1802:
1799:
1798:
1751:chordae tendineae
1724:pectinate muscles
1084:978-0-7295-3752-0
663:first heart sound
582:connective tissue
542:
412:prosthetic valves
383:papillary muscles
375:chordae tendineae
354:Chordae tendineae
243:are known as the
172:
171:
167:
2161:
1971:
1970:
1926:atrial appendage
1890:pulmonary artery
1840:atrial appendage
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1786:cardiac skeleton
1756:papillary muscle
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1408:. Archived from
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1366:. Archived from
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1321:. Philadelphia:
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1247:(6): 1355–1363.
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846:. Philadelphia.
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462:echocardiography
446:left ventricular
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164:edit on Wikidata
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2149:Cardiac anatomy
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2042:
2036:Purkinje fibers
2031:bundle branches
1987:
1958:
1916:pulmonary veins
1900:
1884:pulmonary valve
1868:right ventricle
1864:tricuspid valve
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1729:terminal sulcus
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1624:Anatomy of the
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1539:Further reading
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678:ultrasound scan
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571:Mitral stenosis
565:There are some
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268:mitral stenosis
241:tricuspid valve
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101:valva mitralis,
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75:Tricuspid valve
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2111:Blood supply
1983:heart valves
1945:
1942:aortic sinus
1938:aortic valve
1930:mitral valve
1929:
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1872:infundibulum
1844:fossa ovalis
1836:right atrium
1823:
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1414:. Retrieved
1410:the original
1400:(2): 73–81.
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176:mitral valve
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127:A12.1.04.003
98:
29:Mitral valve
2066:Pericardium
1975:Endocardium
1922:left atrium
1826:venae cavae
1816:Right heart
1667:interatrial
1358:(1): 31–7.
1280:Circulation
692:comes from
667:stethoscope
484:atrial kick
316:Heart valve
225:left atrium
88:Identifiers
2143:Categories
1993:Myocardium
1906:Left heart
1736:ventricles
1416:2015-01-01
1374:2010-03-04
956:1054224262
829:References
757:(purple),
558:media help
453:myocardium
438:See also:
314:See also:
1491:: 88–90.
1458:1875-2136
1187:1525-2167
1127:1016-7315
1055:240154628
996:cite book
988:893557976
917:cite book
909:434319356
870:cite book
862:920806541
688:The word
684:Etymology
499:sphincter
294:Structure
1808:Chambers
1703:Internal
1683:borders
1662:coronary
1566:Archived
1515:24791181
1466:21944149
1406:12439384
1364:12578332
1261:23962462
1226:10901521
1195:20435783
1145:23960615
1047:34714608
807:See also
781:", and "
702:bicuspid
647:thrombus
636:catheter
586:collagen
576:Classic
449:diastole
434:Function
338:Leaflets
276:prolapse
252:diastole
227:and the
2021:AV node
2011:SA node
1640:Surface
1633:General
1506:4005861
1302:5046018
1136:3727372
799:cadaver
765:(red).
724:Gallery
624:replace
514:Disease
444:During
420:systole
398:Annulus
379:tendons
256:systole
231:of the
115:D008943
83:Details
1967:Layers
1882:), →
1763:valves
1558:
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759:pleura
690:mitral
548:valve.
480:A wave
466:E wave
430:root.
288:bishop
1948:aorta
1928:) →
1768:cusps
1714:atria
1687:right
1657:sulci
1626:heart
1569:(PDF)
1552:(PDF)
1051:S2CID
813:Heart
763:heart
755:lungs
751:bones
704:uses
698:mitre
694:Latin
406:is a
286:of a
284:mitre
233:heart
221:cusps
162:[
94:Latin
71:atria
1950:and
1944:) →
1892:and
1862:) →
1692:left
1652:apex
1647:base
1556:ISBN
1511:PMID
1462:PMID
1454:ISSN
1402:PMID
1360:PMID
1327:ISBN
1298:PMID
1257:PMID
1222:PMID
1191:PMID
1183:ISSN
1141:PMID
1123:ISSN
1079:ISBN
1043:PMID
1006:link
1002:link
984:OCLC
974:ISBN
952:OCLC
942:ISBN
923:link
905:OCLC
895:ISBN
876:link
858:OCLC
848:ISBN
777:", "
773:", "
717:cusp
402:The
321:one.
174:The
151:7235
139:3987
122:TA98
110:MeSH
1501:PMC
1493:doi
1444:doi
1440:104
1288:doi
1249:doi
1173:doi
1131:PMC
1115:doi
1033:doi
711:bi-
708:of
626:or
270:).
211:or
146:FMA
134:TA2
2145::
1936:→
1932:→
1920:→
1886:→
1878:,
1874:,
1866:→
1858:,
1854:,
1850:,
1846:,
1842:,
1834:→
1828:,
1564:.
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1489:79
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1093:^
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