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Am J Physiol Heart Circ Physiol 274: H552-H563, 1998;
0363-6135/98 $5.00
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Vol. 274, Issue 2, H552-H563, February 1998

Mitral valve opening in the ovine heart

Matts O. Karlsson1,2, Julie R. Glasson3, Ann F. Bolger4,6, George T. Daughters1,3, Masashi Komeda3, Linda E. Foppiano5, D. Craig Miller3,6
Neil B. Ingels Jr.1,3
(With the Technical Assistance of Carol W. Mead, Mary K. Zasio, Erin M. Schultz, and Terrence Tye)

1 Department of Cardiovascular Physiology and Biophysics, Research Institute, Palo Alto Medical Foundation, Palo Alto, California 94301; 2 Department of Mechanical Engineering, Linköping University, S-581 83 Linköping, Sweden; Departments of 3 Cardiothoracic Surgery, 4 Cardiovascular Medicine, and 5 Anesthesia, Stanford University School of Medicine, Stanford 94305; and 6 Cardiac Surgery and Cardiology Sections, Department of Veterans Affairs Medical Center, Palo Alto, California 94304

To study the three-dimensional size, shape, and motion of the mitral leaflets and annulus, we surgically attached radiopaque markers to sites on the mitral annulus and leaflets in seven sheep. After 8 days of recovery, the animals were sedated, and three-dimensional marker positions were measured by computer analysis of biplane videofluorograms (60/s). We found that the oval mitral annulus became most elliptical in middiastole. Both leaflets began to descend into the left ventricle (LV) during the rapid fall of LV pressure (LVP), before leaflet edge separation. The anterior leaflet exhibited a compound curvature in systole and maintained this shape during opening. The central cusp of the posterior leaflet was curved slightly concave to the LV during opening. Markers at the border of the "rough zone" were separated by 10 mm during systole. We conclude that coaptation occurs very near the leaflet edges, that the annulus and leaflets move toward their open positions during the rapid fall of LVP, and that leaflet edge separation, the last event in the opening sequence, occurs near the time of minimum LVP.

leaflets; annulus; radiopaque markers; coaptation; sheep


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