Adipose-Derived Mesenchymal Stromal Cells in Basic Research and Clinical Applications.

Adipose-derived mesenchymal stromal cells (AD-MSCs) have been extensively studied in recent years. Their attractiveness is due to the ease of obtaining clinical material (fat tissue, lipoaspirate) and the relatively large number of AD-MSCs present in adipose tissue. In addition, AD-MSCs possess a high regenerative potential and immunomodulatory activities. Therefore, AD-MSCs have great potential in stem cell-based therapies in wound healing as well as in orthopedic, cardiovascular, or autoimmune diseases. There are many ongoing clinical trials on AD-MSC and in many cases their effectiveness has been proven. In this article, we present current knowledge about AD-MSCs based on our experience and other authors. We also demonstrate the application of AD-MSCs in selected pre-clinical models and clinical studies. Adipose-derived stromal cells can also be the pillar of the next generation of stem cells that will be chemically or genetically modified. Despite much research on these cells, there are still important and interesting areas to explore.

Clinical anatomy of the spatial structure of the right ventricular outflow tract.

BACKGROUND: The right ventricular outflow tract (RVOT) is located above the supraventricular crest and reaches the level of the pulmonary valve. Detailed knowledge of the RVOT spatial structure and its morphology is extremely important for cardiac invasive therapeutic procedures. OBJECTIVES: To examine the spatial structure of the RVOT using virtual models of the right ventricle (RV) interior obtained post mortem. MATERIAL AND METHODS: The study was carried out using 40 adult hearts from both sexes fixed in formalin. Donors had a negative history of cardiovascular diseases. Silicone models of the interior of the RV were made and then subjected to a digital modelling procedure using the photogrammetry technique. For each 3D model of the RV, the RVOT was extracted and measurements were performed. RESULTS: Statistical analysis demonstrated that the dimensions of the transverse (p < 0.001) and sagittal (p = 0.002) axis at the level of the upper and lower border of the RVOT differed significantly. There was also a significant difference between the right and left height of the RVOT (p = 0.009). A clear correlation was found between the volume of the RVOT and the volume of the entire RV (r = 0.718, p < 0.001). CONCLUSIONS: The obtained 3D models of the RVOT can help standardize the data related to RVOT architecture. Furthermore, they can extend knowledge about the RVOT in the field of cardiology and improve the procedures in cardiac surgery.

Cardiovascular and Respiratory Toxicity of Protamine Sulfate in Zebrafish and Rodent Models.

Protamine sulfate (PS) is the only available option to reverse the anticoagulant activity of unfractionated heparin (UFH), however it can cause cardiovascular and respiratory complications. We explored the toxicity of PS and its complexes with UFH in zebrafish, rats, and mice. The involvement of nitric oxide (NO) in the above effects was investigated. Concentration-dependent lethality, morphological defects, and decrease in heart rate (HR) were observed in zebrafish larvae. PS affected HR, blood pressure, respiratory rate, peak exhaled CO2, and blood oxygen saturation in rats. We observed hypotension, increase of HR, perfusion of paw vessels, and enhanced respiratory disturbances with increases doses of PS. We found no effects of PS on human hERG channels or signs of heart damage in mice. The hypotension in rats and bradycardia in zebrafish were partially attenuated by the inhibitor of endothelial NO synthase. The disturbances in cardiovascular and respiratory parameters were reduced or delayed when PS was administered together with UFH. The cardiorespiratory toxicity of PS seems to be charge-dependent and involves enhanced release of NO. PS administered at appropriate doses and ratios with UFH should not cause permanent damage of heart tissue, although careful monitoring of cardiorespiratory parameters is necessary.

Individual variability of vascularization of the anterior papillary muscle within the right ventricle of human heart.

BACKGROUND: To date there is scarce published evidence reporting the dual blood supply reaching anterior papillary muscle (APM), which descends from both major coronary arteries. Such a vascular configuration can prevent the dysfunction of right ventricular entire valvular system in case of the occlusion of proximal part of either right coronary artery (RCA) or left coronary artery (LCA). The aim of our study was to determine the vascular pattern of APM blood supply which originates from two main coronary arteries, in the context of the APM and septomarginal trabecula (SMT) topography. METHODS: The study was carried out using tissue obtained from 36 human hearts. The material was divided into four morphological types of SMT/APM arrangement. Vascularization and blood supply pattern of papillary muscle was investigated following the analysis of multiple tissue cross sections. The origin of APM arterial supply was traced back to both main coronary arteries. Cross-sectional area of the arteries was estimated at the base of APM and compared within mixed male-female population, aged 18-76. RESULTS: We noted that as much as 78% of entire APM material had a blood supply vasculature originating from both LCA and RCA branches. In contrast, 22% of cases APM was supplied by a single coronary artery, while in each case it proved to be LCA. We have never found APM arterial supply provided exclusively by RCA. In case of double AMP blood supply an average of total cross-section area of the arteries branching from LCA, was noted to be in excess of two and a half times bigger in type III and more than two times bigger in type IV, as compared with the arteries originating from RCA. CONCLUSIONS: Our research confirm the possibility of double blood supply which vascularizes APM, but the finding does not necessarily apply in all cases. However, APM seems to be predominantly vascularized by arteries deriving from LCA, regardless of their morphological type.

The structure of the vascular system of the septomarginal trabecula in the heart of an adult.

BACKGROUND: In cardiology, the paths of the arteries penetrating the septomarginal trabecula (SMT) are especially important. They provide blood supply to the apparatus of the right atrioventricular orifice and often form anastomoses with the system of the right coronary artery. Despite this, only a few publications discuss the morphological aspect of the septomarginal trabecula, and available histological analyses seldom deal with its blood supply. OBJECTIVES: The aim of this study was to analyze the vessel structure of the septomarginal trabecula in terms of the variability of the area of the cross-section of the lumen and the muscular layer of the artery. MATERIAL AND METHODS: The study was carried out on the material of 50 human hearts from adults of both sexes. The material was divided into 4 morphological types. Histological examinations were conducted by means of classic staining methods. RESULTS: At the initial cross-section of the septomarginal trabecula, the area of the cross-section increased to half of the length of the trabecula, and then it started to decrease. This is connected with the thickening of the inner muscular layer of the artery, which proportionally takes up more area of the cross-section of the whole artery of the SMT. The total area of the cross-section of all vessels in both types examined was also the largest in the middle part of the SMT. Furthermore, the results of this study confirm the presence of a connection between both systems of coronary arteries. CONCLUSIONS: As the septomarginal trabecula passes through the lumen of the right ventricle, its arteries become exposed to the influence of the factors which may evoke a biological response from the walls of this vessel, causing the thickening of the muscular layer and, as a result, of the section of the whole artery, in particular its middle part.

Variability of the Left Atrial Appendage in Human Hearts.

Atrial fibrillation increases the risk of thrombus formation. It is commonly responsible for cerebral stroke whereas less frequently for pulmonary embolism. The aim of the study was to describe the morphology of the left atrial appendage in the human heart with respect to sex, age and weight. Macroscopic examination was carried out on 100 left appendages taken from the hearts of the patients aged 18-77, both sexes. All hearts preserved in 4% water solution of formaldehyde carried neither marks of coronary artery disease nor congenital abnormalities. Three axes of appendage orientation were performed. After the appendage had been cut off, morphological examination was performed in long and perpendicular axes. Measurements of the appendages were taken from anatomical specimens and their silicone casts. We classified the left atrial appendage into 4 morphological groups according to the number of lobes. Most left atrial appendages in female population were composed of 2 lobes. In the male group typically 2 or 3-lobed appendages were observed. The mean left atrial appendage orifice ranged from 12.0 to 16.0 mm and the most significant difference in the orifices between males and females was observed in LAA type 2 (about 3.3 mm). A smaller orifice and narrower, tubular shape of the LAA lobes could explain a higher risk of thrombus formation during nonvalvular atrial fibrillation in women. Knowledge of anatomical variability of the LAA helps diagnose some undefined echoes in the appendage during transesophageal echocardiographic examination.

Macroscopic morphology of right atrial appendage in humans.

BACKGROUND AND AIM: Atrial fibrillation (AF) is a common arrhythmia in elderly people, and in many cases it is responsible for stroke or pulmonary embolism. One of the factors facilitating atrial thrombus formation is anatomical morphology of the atria, and especially the appendages. The pharmacological treatment of arrhythmia is generally focused on ventricular rate control. Electrical cardioversion is the preferred treatment method in the majority of clinics but it can occasionally produce the potentially dangerous complication of AF. METHODS: A macroscopic study was carried out on 40 (25 male [M], 15 female [F]) human hearts, 18-72 years of age, and a microscopic study in a group of 20 human right atrial appendages (RAA) (M 10, F 10), 18-72 years of age. Only hearts without anomalies were included in the study. Classical anatomical studies and statistic analyses were applied. RESULTS AND CONCLUSIONS: RAA is triangle shaped with a mean area of 2.73 cm2. Muscle fascicules build the wall of RAA and compose a dense net inside a chamber. Sagittal bundle connecting terminal crest with an apex of RAA was observed in all examined hearts. In microscopic specimens longitudinal and perpendicular fascicles were described.

Endoscopic submucosal dissection of gastric ectopic pancreas.

Patients with gastric tumors usually present with symptoms of discomfort or pain in the epigastrium, regurgitations, nausea, vomiting or melena. Treatment options include open and laparoscopic total or partial gastrectomy and recently endoscopic mucosal resection. A case of successful endoscopic submucosal dissection is described with the unusual pathological finding of heterotopic pancreatic tissue forming a gastric tumor. The 67-year-old male patient was operated on due to the initial diagnosis of gastro-intestinal stromal tumor of the gastric trunk. Two intra-operative biopsies were negative for cancer cells. Submucosal endoscopic dissection was performed with IT and Hook knives (Olympus). A literature review was performed. The operative time was 180 min with hospital stay of 6 days. During the injection of the carmine dye and the air insufflation pneumoperitoneum occurred and remained clinically silent during the observation period. The pathology result showed a heterotopic pancreatic tissue type 2 according to Heinrich's classification with microfoci of intestinal metaplasia. Preoperative diagnostics of gastric masses might be misleading and such tumors not necessarily should be excised. There are several surgical options with endoscopic submucosal dissection being probably the safest one and a non-disabling approach. Patients tolerate that kind of surgery well with good postoperative functional outcomes.

Tracheo-bronchial angles in the human fetus -- an anatomical, digital, and statistical study.

BACKGROUND: Both the advancement of visual techniques and intensive progress in perinatal medicine result in performing airway management in the fetus and neonate affected by life-threatening malformations. This study aimed to examine the 3 tracheo-bronchial angles, including the right and left bronchial angles, and the interbronchial angle, in the fetus at various gestational ages. MATERIAL AND METHODS: Using methods of anatomical dissection, digital image analysis with an adequate program (NIS-Elements BR 3.0, Nikon), and statistics, values of the two bronchial angles and their sum as the interbronchial angle were semi-automatically measured in 73 human fetuses at the age of 14-25 weeks, derived from spontaneous abortions and stillbirths. RESULTS: No male-female differences between the parameters studied were found. The 3 fetal tracheo-bronchial angles were found to be independent of age. The right bronchial angle ranged from 11.4° to 41.8°, and averaged 26.9±7.0° for the whole analyzed sample. The values of left bronchial angle varied from 24.8° to 64.8°, with the overall mean of 46.2±8.0°. As a consequence, the interbronchial angle totalled 36.2-96.6°, and averaged 73.1±12.7°. CONCLUSIONS: The tracheo-bronchial angles change independently of sex and fetal age. The left bronchial angle is wider than the right one. Values of the 3 tracheo-bronchial angles are unpredictable since their regression curves of best fit with relation to fetal age cannot be modelled. Both of the 2 bronchial angles and the interbronchial angle are of great relevance in the location of inhaled foreign bodies, and in the diagnosis cardiac diseases and mediastinal abnormalities.

Morphometric study of the T6 vertebra and its three ossification centers in the human fetus.

PURPOSE: Knowledge on the normative growth of the spine is critical in the prenatal detection of its abnormalities. We aimed to study the size of T6 vertebra in human fetuses with the crown-rump length of 115-265 mm. MATERIALS AND METHODS: Using the methods of computed tomography (Biograph mCT), digital image analysis (Osirix 3.9) and statistics, the normative growth of the T6 vertebral body and the three ossification centers of T6 vertebra in 55 spontaneously aborted human fetuses (27 males, 28 females) aged 17-30 weeks were studied. RESULTS: Neither male-female nor right-left significant differences were found. The height, transverse, and sagittal diameters of the T6 vertebral body followed natural logarithmic functions as y = -4.972 + 2.732 × ln(age) ± 0.253 (R (2) = 0.72), y = -14.862 + 6.426 × ln(age) ± 0.456 (R (2) = 0.82), and y = -10.990 + 4.982 × ln(age) ± 0.278 (R (2) = 0.89), respectively. Its cross-sectional area (CSA) rose proportionately as y = -19.909 + 1.664 × age ± 2.033 (R (2) = 0.89), whereas its volumetric growth followed the four-degree polynomial function y = 19.158 + 0.0002 × age(4) ± 7.942 (R (2) = 0.93). The T6 body ossification center grew logarithmically in both transverse and sagittal diameters as y = -14.784 + 6.115 × ln(age) ± 0.458 (R (2) = 0.81) and y = -12.065 + 5.019 × ln(age) ± 0.315 (R (2) = 0.87), and proportionately in both CSA and volume like y = -15.591 + 1.200 × age ± 1.470 (R (2) = 0.90) and y = -22.120 + 1.663 × age ± 1.869 (R (2) = 0.91), respectively. The ossification center-to-vertebral body volume ratio was gradually decreasing with age. On the right and left, the neural ossification centers revealed the following models: y = -15.188 + 6.332 × ln(age) ± 0.629 (R (2) = 0.72) and y = -15.991 + 6.600 × ln(age) ± 0.629 (R (2) = 0.74) for length, y = -6.716 + 2.814 × ln(age) ± 0.362 (R (2) = 0.61) and y = -7.058 + 2.976 × ln(age) ± 0.323 (R (2) = 0.67) for width, y = -5.665 + 0.591 × age ± 1.251 (R (2) = 0.86) and y = -11.281 + 0.853 × age ± 1.653 (R (2) = 0.78) for CSA, and y = -9.279 + 0.849 × age ± 2.302 (R (2) = 0.65) and y = -16.117 + 1.155 × age ± 1.832 (R (2) = 0.84) for volume, respectively. CONCLUSIONS: Neither sex nor laterality differences are found in the morphometric parameters of evolving T6 vertebra and its three ossification centers. The growth dynamics of the T6 vertebral body follow logarithmically for its height, and both sagittal and transverse diameters, linearly for its CSA, and four-degree polynomially for its volume. The three ossification centers of T6 vertebra increase logarithmically in both transverse and sagittal diameters, and linearly in both CSA and volume. The age-specific reference intervals for evolving T6 vertebra present the normative values of potential relevance in the diagnosis of congenital spinal defects.

False chordae tendineae in right ventricle of adult human hearts - morphological aspects.

INTRODUCTION: False chordae tendineae are fibrous-muscular bundles which do not interconnect with right atrioventricular valves. The structures have occasionally been described in the right ventricle. There are reports suggesting their influence on electromechanical processes taking place in the heart, in thromboembolic events as well as in the course of cardiac invasive procedures. The objective of the study was to perform a macroscopic evaluation of false chordae tendineae in the right ventricle. MATERIAL AND METHODS: The research specimens consisted of 100 hearts of adult humans, aged from 18 to 59 years, fixed in a solution of 10% formaldehyde and 98% ethanol. The ratio of false chordae tendineae to individual elements of the right ventricle, such as its walls, papillary muscles, septomarginal trabecula and the apex of the ventricle, was examined. RESULTS: During examination, six types of chordae tendineae were described based on the criterion of the type of structures they connected. The most common were false chordae connecting ventricle walls within its apex, while the least common were individual segments of papillary muscles. The research proved that the examined structures are morphologically extremely diverse. Substantial clinical implications of their presence seem very probable. CONCLUSIONS: The present work is the first of a scheduled series devoted to the problem of false chordae tendineae. Further analyses will cover the subject of morphological aspects in a microscopic perspective.

Quantitative anatomy of the growing abdominal aorta in human fetuses: an anatomical, digital and statistical study.

BACKGROUND: Advances in perinatal medicine have required an extensive knowledge of fetal aorto-iliac measurements. The present study was performed to compile reference data for dimensions of the abdominal aorta at varying gestational ages. MATERIAL/METHODS: Using the methods of anatomical dissection, digital-image analysis (Leica QWin Pro 16 system), and statistical analysis (Student's t-test, one-way ANOVA, post-hoc RIR Tukey test, regression analysis, and Wilcoxon signed-rank test), the growth of length (mm), proximal and distal external diameters (mm), and volume (mm3) of the abdominal aorta in 124 (60 male, 64 female) spontaneously aborted human fetuses aged 15-34 weeks was examined. RESULTS: No significant male-female differences were found. The length ranged from 9.35±1.24 to 36.29±4.98 mm, according to the linear function y=-14.596+1.519 × Age ±2.639 (R2=0.92; p<0.0001). The proximal external diameter varied from 1.18±0.25 to 5.19±0.49 mm, according to the linear pattern y=-2.065+0.212 × Age ±0.348 (R2=0.92; p<0.0001). The distal external diameter increased from 1.03±0.23 to 4.92±0.46 mm, in accordance with the linear model y=-2.097+0.203 × Age ±0.351 (R2=0.92; p<0.0001). Both length and proximal external diameter of the abdominal aorta indicated a proportionate evolution, because the length-to-proximal external diameter ratio was stable, following the linear function y=7.724-0.017 × Age ±0.925. The abdominal aorta volume ranged from 9.6±4.5 to 740.5±201.8 mm3, given by the quadratic function y=911-101 × Age +2.838 × Age2 ±78 (R2=0.89; p<0.0001). CONCLUSIONS: There are no significant differences between males and females for morphometric parameters of the abdominal aorta. The abdominal aorta grows linearly in both length and diameters, and parabolically in volume. These detailed morphometric data of the abdominal aorta provide a database for intra-uterine echographic examinations in the early diagnosis, monitoring and management of aorto-iliac malformations.

Morphological remarks regarding the structure of conduction system in the right ventricle.

BACKGROUND: The knowledge of conduction system morphology has a vital significance in cardiology and cardiac surgery - it enables to interpret pathologies and choose treatment. This has been confirmed by numerous accounts, both in the context of e.g. atrial fibrillation ablations as well as treating septum defects. Due to diversity and changeability of conduction system structure and their clinical implications, its thorough analyses seem to bear special importance. AIM: To examine the structure of selected elements of conduction system present in the right ventricle (RV). METHODS: Elements of conduction system present in RV of 6 foetuses (from 12 to 32 weeks of foetus age), 6 children (from 1 day to 7-year-old) and 10 adults (from 37 to 79-year-old) were histologically examined. Cross sections of 10 moderator bands and 10 anterior papillary muscles of adult human hearts were made. Specimens including membranous and muscular parts of the septum along with diverging moderator band were taken from a group of foetus, child and adult hearts. Cuttings of 10 micron width were stained with Masson's method in Goldner's modification. On the basis of the sections of membranous and muscular parts of the septum, the continuities of the elements of the conduction system were analysed. RESULTS: It was observed that in most cases the right branch of His' bundle locates itself deep in the muscular tissue of the septum irrespective of age; it is clearly separate along its whole run and gradually penetrates the muscular tissue with its fibers. Hardly ever does the right branch of His' bundle locate itself on the surface, subendocardially, with a minimum penetration into the muscular tissue. Moreover, in most cases, elements of conduction system are present in moderator band. The main tissue constituting its stroma is above all muscular tissue and to a lesser extent, connective tissue. In addition to this, fat tissue in variable proportion was also observed. In cross sections of the moderator band a distinctively circumscribed stripe of fibers of the conduction system was found. However, one could also observe samples in which its identification was not possible. CONCLUSIONS: The right branch of His bundle within the muscular part of the septum in most cases is located intramuscularly irrespective of age. The results of analyses prove a relatively constant character of the presence of the conduction system within the moderator band.

Assessment of a single monomorphic ventricular ectopy from the right ventricular outflow tract in standard and high resolution electrocardiogram.

INTRODUCTION: High-resolution electrocardiography (ECG-CREM) is a method based on digital electrocardiography. In order to facilitate the interpretation of the Crem records the technique of vectorcardiography was used. In comparison the origin of the ventricular premature complexes (VPCs) could be estimated based on a standard 12-lead electrocardiogram. The aim of the study was to assess the point of origin of the VPCs in ECG-CREM and correlate it with standard electrocardiography (ECG-Stand). MATERIAL AND METHODS: Our study included 26 patients (16 females, 10 males), aged 51-83 years (avg. 58.1 ±12.3), who presented with recurrent, during at least 6 months' observation, VPCs. The point of origin of VPCs was compared in both methods. RESULTS: The performed analysis of collected ECG-Stand records revealed the presence of arrhythmogenic focal points in six different locations (1, 3, 5, 7, 8, 9). However, we did not affirm their presence in points 2,4,6. They were most commonly located in RVOT zones 8 (30.7%), 9 (23.0%), 5 (23.0%), and most seldom in zones 1, 3, 7 (7.6% each). In the simultaneous record of ECG-CREM with a single VPC it was confirmed that the FPb zone was activated the most frequently (40.0%); the next in relation to frequency were SD and ST (20.0%). Less frequent VPCs have their origin in Crem zones SP, FPa and SB (6.6%). CONCLUSIONS: Electrocardiogram of high signal resolution (ECG-CREM) might be useful in recognition of the origin of ventricular premature complexes from RVOT.

Morphogenetic aspects of the septomarginal trabecula in the human heart.

INTRODUCTION: The septomarginal trabecula is a constant element of the anatomy of the human heart, which connects the interventricular septum and the anterior wall of the right ventricle. Considering the diversity of opinions about the structure and numerous studies suggesting its important role in haemodynamics and conduction of electrical impulses in the heart, we decided to study this element in detail. MATERIAL AND METHODS: The research was conducted on 220 human hearts. Attention was mainly paid to the structure and topography of the trabecula. Its relation to the anterior papillary muscle was also a part of the study. RESULTS: The presence of this morphologically diverse element was confirmed in each of the studied hearts. In most cases the trabecula originated from the upper part of the interventricular septum, separating at an angle increasing proportionally to the number of branches of the crista supraventricularis as well as the number of secondary trabeculae. The criteria established for the study, which included the course of the trabecula in the lumen of the right ventricle and its relation to the anterior papillary muscle, let us distinguish 4 types of septomarginal trabecula (I, II, III, IV). The most common was type III, the undivided trabecula, tightly connecting with the anterior papillary muscle. CONCLUSIONS: Based on the results of the following study we propose a hypothesis on the genesis of respective parts of the septomarginal trabecula and a plausible sequence of changes they undergo during human ontogenesis and phylogenesis of the primates.

The crista supraventricularis in the human heart and its role in the morphogenesis of the septomarginal trabecula.

The crista supraventricularis and septomarginal trabecula are common elements of the right ventricle, and determine many hemodynamic phenomena. The morphological analysis of both structures in regard to their mutual relations was the aim of this study. The study was carried out on the material of preserved human hearts--fetuses, children and adults. The size and development of the crista supraventricularis was carefully evaluated. The division of its lower part, and hence the possibilities of development of the septomarginal trabecula, was divided into five types (A, B, C, D and E). The most common was type B, containing two muscular trabeculae. The width of the crista varied 1/5-3/5 of the width of the interventricular septum. On the basis of this study, a conclusion of morphological unity of the septomarginal trabecula and crista supraventricularis was drawn.

Remarks on the morphology of the papillary muscles of the right ventricle.

In addition to the papillary muscles of right ventricle referred to in anatomical nomenclature, namely the anterior, posterior and septal, we have distinguished the "conal papillary muscle" and the "papillary muscle of the posterior angle of the right ventricle". The conal papillary muscle was described by Luschka in the 17(th) century as the most constant of the septal papillary muscles. We have distinguished the muscles of the posterior angle of the right ventricle as muscles which would not be clearly classified as either septal or posterior muscles. Moreover, the muscles of the posterior angle of the right ventricle are probably associated with the transfer of the papillary muscles from the septum to the posterior wall of the right ventricle during phylogenetic evolution. Some researchers have classified them with the septal papillary muscles, while others have assigned them to the posterior group. The morphology of the muscles was classified using earlier categories for the posterior papillary muscles only. We have adopted the concept of multi-apical and multi-segmental muscles.

Unusual anatomical features of the right atrioventricular valve.

Despite the great interest taken in the tricuspid valve, the anatomical literature on the subject still leaves much open to question. The aim of this study was to describe the natural foramina which are present in the leaflets of the tricuspid valve, as well as, well -- founded onto -- and phylogenetically lack of continuity of its attachment and the frenula of the tricuspid valve. We studied the frequency of occurrence and morphology of these features of the tricuspid valve in 107 adult hearts.

Notes on the morphology of the tricuspid valve in the adult human heart.

Rapid progress in the field of interventional cardiology has caused research in the field of morphometry of the heart to be in constant demand. In this study, performed on a group of 75 adult human hearts, the authors have attempted to assess the form and number of the main and accessory cusps in the tricuspid valve. We have classified particular forms into 8 groups, depending on the number of cusps and we have divided the cusps into 3 main groups, depending on the support of the chordae tendineae.