[HSF] mitral valve nomenclature

[Nasser F. Abou'Seada]

Dear Bob 
Do you have a pdf of your designated papers ?? ......that would be great
....

As you know, as per our communication before you attended the SAHARA
meeting, I have submitted a paper to the meeting of the BHI -Al-Bassel Heart
Institute- in Damascus, posing a preliminary query as to the validity of our
current system of nomenclature of the Mitral valve apparatus, specifically
as seen from the reconstructive perspective of a Surgeon's eye. 

The main theme was that -IMHO- One should recognize the current system of
nomenclature, as from a surgical topographical perspective, rather than as
in a perfect anatomical perspective, just for the purpose of unifying the
surgical findings and nomenclature specifically during a session of
reconstruction. 

The main issue is -IMHO- to use that topographical nomenclature as related
to reconstructive purposes .... nonetheless keeping anatomical description
for anatomical purposes. 

The paper imposes no definite system, rather than to use what is already in
use by surgeons during surgery. 

I think the point of TEA is clearly and concisely descriptive of the issue,
as I want to put it ... though not having his mastership of configuring the
ideas and concepts and formulating the words .... no doubt ... 

I'll be happy to post the slides, should that be of any help ... 

NFA

> From: Rwmfglycar at aol.com
> Dear Tea,
> Read the editorial by Robert H Anderson and Robert W M  Frater in  the
> November issue of the Journal of Heart Valve Disease. "How can we best
describe the
> components of the mitral valve?".There is also a very well  illustrated
> article by Vijaya Nayak and my friend the late Victor Solomon  (a great
anatomist)
> in the same issue on the subject of the gross chordal  anatomy of the
"Aortic"
>  leaflet of the mitral valve. Looking at the  pictures makes it obvious
why
> you have trouble defining the details of this  anatomy by MRI.
> Both Bob Anderson and I believe that the only way to describe cardiac
> anatomy is the classical way, assuming the patient is standing erect with
anterior
> , posterior and left and right sides. Multislice CT is good at defining
> attitudinally correct anatomical descriptions.That is what I used when I
suggested
> the correct descriptions of the papillary muscles are Left Superior  and
> Right Inferior.
> You are right that the Anterior leaflet is not unequivocally, indubitably
> and always anterior as our noses are. I think Aortic and Mural are good
terms
> for what we commonly call Anterior and Posterior. A very major problem in
> naming mitral anatomy is its gross irregularity. Alpha-numeric systems
invariably
> have exceptions and the user finds himself forcing what he sees to
conform
> to the system he is using.The other issue is persuading surgeons to  think
of
> what they see in a supine human with the table tilted one way and  the
heart
> retracted another way as something deserving of an attitudinally  correct
> description.
> By the way Nasser and Prasanna are interested in this subject. Obviously a
> subject for Wiki but not one to be lightly undertaken. Prasanna recognised
my
> description of the papillary muscles long before I wrote about it.
> I would dearly like to sit with you with heart specimens in hand  and
dynamic
> MRI's running to try to sort this out.
> Bob
> Anderson RH, Frater RWM. How can we best describe the components of the
> mitral valve? J Heart Valve Dis 2006;15:736-739
> Frater RWM. Attitudinally Correct Nomenclature of Papillary Muscles. J
Heart
> Valve Dis 2003;12:548-550
> 
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