By Hideaki Senzaki, Satoshi Yasukochi
This booklet comprehensively covers the newest information regarding ventricular–vascular morphology and serve as in congenital middle disorder (CHD) assessed by way of quite a few cutting edge methodologies.
Anatomical (morphological) abnormalities in CHD are quite often followed with irregular loading stipulations, which, in flip, reason ventricular and vascular sensible impairments. The practical impairments can also exist independently of the anatomical abnormalities. those (morphological and useful abnormalities) importantly engage to figure out underlying pathophysiology and generate scientific signs in CHD. as a result, particular and distinctive evaluation of morphology and serve as is vital to higher comprehend and deal with this illness. fresh advances in expertise have supplied invaluable instruments for this goal, and novel findings are amassing. the knowledge contained right here will offer researchers and clinicians with valuable wisdom during this field.
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Additional resources for Congenital Heart Disease: Morphological and Functional Assessment
However, as the dysfunction and dilation of the right ventricle progressed, tethering of the septal leaﬂet by the chordae from the septum became prominent, and regurgitation deteriorated. 2 Assessment of Atrioventricular Valve Anatomy and Function in Congenital. . 31 Fig. 9 Tricuspid valve in hypoplastic left heart syndrome. (a) An en face image of a tricuspid valve in the closed position obtained using transthoracic three-dimensional echocardiography. (b) A corresponding image to that in panel A obtained using color Doppler three-dimensional echocardiography.
Leaﬂet stress is calculated based on the von Mises distortion energy theory. A warm color is associated with higher stress (Salgo et al. ; with permission) leaﬂet expands its area by as much as about 50 % by stretching its undulated collagen ﬁbers [20, 21]. The leaﬂet expands to its limit very quickly at the beginning of valve closure. This expansion is followed by a plateau phase and a dramatic increase of leaﬂet stiffness to prevent further leaﬂet deformation. To cope with leaﬂet stress, the leaﬂet is conﬁgured into a curved surface during the systolic phase, which is called billowing.
The atrialis is the surface layer adjacent to the atrium, which is composed of elastic and collagen ﬁbers covered with overlying endothelium. The spongiosa largely consists of extracellular matrix, proteoglycans and glycosaminoglycans, and elastic ﬁbers. The spongiosa is the major component of the free edge and acts as a cushion to protect the leaﬂet from the impulse of valve closure. Beneath the spongiosa is the ﬁbrosa, which is comprised of collagen ﬁbers and is located close to the ventricular surface extending to the chordae tendineae.