Morphology, microstructure and biomechanical properties of tendinous cords of heart – a systematic review of cadaveric studies

Year 2025, Volume: 19 Issue: 1, 30 - 40, 30.04.2025

Raman Ambiga , Suman Verma

https://izlik.org/JA76KS25RX

Abstract

Objectives: The rupture of tendinous cords (TC), affects the proper functioning of the atrioventricular (AV) valves and requires replacement by the prosthetic chordae. The morphology and ultrastructure of TC are vital to design prosthesis and to prevent the treatment failure.
Methods: The databases like PubMed, Google Scholar, Science direct and Scopus were searched till June 2024. The keywords used were TC, chordae, TC anatomy, TC morphology, TC morphometry, TC histology, TC ultrastructure, TC blood supply, TC development, TC embryology, TC biomechanical properties, strut chordae, false chordae, basal TC, and subvalvular apparatus. Out of 2545 articles collected, 43 were finally included.
Results: Majority of human studies were on the hearts from formalin-embalmed cadavers. There were more number of studies (28 studies) examining TC of left ventricle, than that of the right (8 studies). The number of chordae from anterior papillary muscle were greater in number than that from the posterior muscle in both the ventricles. In the left ventricle, anterior papillary muscle chordae were longer and broader. Maximum chordae inserted on the rough zone of mitral and tricuspid valves. Human chordae were structurally more rigid than the animal chordae. The arrangement of collagen bundles inside TC was orthogonal in human, but random and irregular in animal tissues.
Conclusion: This review outlines the details on the morphology, ultrastructure, and biomechanical properties of TC which would aid formulate appropriate reparative procedures to prevent postoperative complications and recurrence.

Keywords

chordae tendinae , heart ventricles , morphology , papillary muscle , review , tendinous cords

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