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Lookup NU author(s): Professor Bob Anderson
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The Authors. Journal of Anatomy published by John Wiley & Sons Ltd on behalf of Anatomical Society.Despite centuries of investigation, certain aspects of left ventricular anatomy remain either controversial or uncertain. We make no claims to have resolved these issues, but our review, based on our current knowledge of development, hopefully identifies the issues requiring further investigation. When first formed, the left ventricle had only inlet and apical components. With the expansion of the atrioventricular canal, the developing ventricle cedes part of its inlet to the right ventricle whilst retaining the larger parts of the cushions dividing the atrioventricular canal. Further remodelling of the interventricular communication provides the ventricle with its outlet, with the aortic root being transferred to the left ventricle along with the newly formed myocardium supporting its leaflets. The definitive ventricle possesses inlet, apical and outlet parts. The inlet component is guarded by the mitral valve, with its leaflets, in the normal heart, supported by papillary muscles located infero-septally and supero-laterally. There is but a solitary zone of apposition between the leaflets, which we suggest are best described as being aortic and mural. The trabeculated component extends beyond the inlet to the apex and is confluent with the outlet part, which supports the aortic root. The leaflets of the aortic valve are supported in semilunar fashion within the root, with the ventricular cavity extending to the sinutubular junction. The myocardial-arterial junction, however, stops well short of the sinutubular junction, with myocardium found only at the bases of the sinuses, giving rise to the coronary arteries. We argue that the relationships between the various components should now be described using attitudinally appropriate terms rather than describing them as if the heart is removed from the body and positioned on its apex.
Author(s): Crucean A, Spicer DE, Tretter JT, Mohun TJ, Cook AC, Sanchez-Quintana D, Hikspoors JPJM, Lamers WH, Anderson RH
Publication type: Review
Publication status: Published
Journal: Journal of Anatomy
Year: 2024
Pages: epub ahead of print
Online publication date: 17/04/2024
Acceptance date: 27/03/2024
ISSN (print): 0021-8782
ISSN (electronic): 1469-7580
Publisher: John Wiley and Sons Inc
URL: https://doi.org/10.1111/joa.14048
DOI: 10.1111/joa.14048
PubMed id: 38629319
Data Access Statement: Not applicable.
