1. Philipp Blanke et al. JIMG 2015;8:612-615
Saddle-Shaped and D-Shaped Mitral Annulus: Definition and 3-Dimensional Structure The saddle-shaped annulus includes the aortomitral continuity, whereas the D-shaped annulus is defined as being limited anteriorly by the trigone-to-trigone (TT) distance, excluding the aortomitral continuity. The different 3-dimensional configurations are illustrated by volume-rendered blood pool inversion images in A, viewed from the left atrium and the annular segmentation in B. The trigones (red dots) form the nadirs of the saddle-shaped annulus and define the TT-distance. The main driver of the concept of the D-shaped annulus is the inevitable obstruction of the left ventricular outflow tract (LVOT) if a valve were to be implanted the size of the projected area of the saddle-shaped annulus as illustrated in a 3-chamber view in C. AML = anterior mitral leaflet; LC = left coronary cusp; NC = noncoronary cusp.
Philipp Blanke et al. JIMG 2015;8:
2015 American College of Cardiology Foundation