Fibrous Skeleton of the Heart: Anatomic Overview and Evaluation of Pathologic Conditions with CT and MR Imaging
- 1 September 2017
- journal article
- review article
- Published by Radiological Society of North America (RSNA) in RadioGraphics
- Vol. 37 (5), 1330-1351
- https://doi.org/10.1148/rg.2017170004
Abstract
This review provides a comprehensive overview of the anatomy of the fibrous skeleton of the heart and its related components, supported by relevant images of anatomy and pathologic processes. The fibrous skeleton is concentrated at the base of the ventricular mass. It provides electrical insulation at the atrioventricular level and fibrous continuity for the leaflets of the mitral, aortic, and tricuspid valves. Its components include the fibrous trigones, the fibrous area of aortic-mitral continuity, the subvalvar collar of the mitral valve, the membranous septum, the interleaflet triangles, the tendon of Todaro, and likely the conus ligament. The majority of the mitral annulus is fibrous, but the only true fibrous part of the tricuspid annulus is where the valvar leaflets are attached to the central fibrous body. At the aortic annulus, the fibrous elements support only the noncoronary aortic sinus and parts of the right and left coronary sinuses. The ring-shaped annulus of the arterioventricular valves as localized with imaging techniques (imaging annulus) differs from the crown-shaped hemodynamic annulus of the arterial valves. The imaging annulus corresponds to the plane passing through the...This publication has 59 references indexed in Scilit:
- Insights regarding the normal and abnormal formation of the atrial and ventricular septal structuresClinical Anatomy, 2015
- The Development of Septation in the Four‐Chambered HeartThe Anatomical Record, 2014
- Myocardial fibroblast–matrix interactions and potential therapeutic targetsJournal of Molecular and Cellular Cardiology, 2014
- Partitioning the heart: mechanisms of cardiac septation and valve developmentDevelopment, 2012
- The clinical anatomy of the mitral valveClinical Anatomy, 2008
- Periostin expression by epicardium-derived cells is involved in the development of the atrioventricular valves and fibrous heart skeletonDifferentiation, 2008
- Annulus Fibrosus of the Mitral Valve: Reality or MythJournal of Cardiac Surgery, 2007
- Origin, Fate, and Function of Epicardium-Derived Cells (EPDCs) in Normal and Abnormal Cardiac DevelopmentThe Scientific World Journal, 2007
- Is there such a thing as the “tendon of the infundibulum” in the heart?Clinical Anatomy, 1997
- Heart and Coronary ArteriesPublished by Springer Science and Business Media LLC ,1975