INTRODUCTION
The right atrioventricular valve (RAV) is an important anatomical
structure of the human heart which prevents blood backflow from the
right ventricle to the right atrium. RAV regurgitation is common,
although it is mostly asymptomatic. It is typically diagnosed
incidentally or when the pathology has led to severe clinical symptoms
(1). Disorders of the RAV are mainly treated with surgical techniques
(2). However, these procedures are challenging and have a high risk of
complications (2–4). Therefore, clinicians are exploring less invasive
treatment alternatives (5,6). Several promising techniques and devices
are currently in development. These include the FORMA spacer device, the
Trialign device, the Caval Valve Implantation (CAVI), the TriClip device
and many others (5,7–9). It is anticipated that minimally invasive
procedures will become routine options for patients with
contraindications to classical cardiac surgery (6,7).
The RAV is a sophisticated morphological entity. The complex anatomy of
the RAV has lowered the success rate of surgical and transcatheter
procedures performed within the area (10,11). For instance, although the
RAV is commonly referred to as the tricuspid valve, a recent study found
that almost 40% of examined specimens had 4 distinct leaflets (10). The
RAV had a lot more diversity in the shapes and sizes of its scallops,
commissures, tendinous chords and papillary muscles (12). The RAV
annulus was found to have an irregular and nonplanar shape (13).
Finally, there was even significant variability in the anatomic
landmarks and locations of each leaflet and commissure. Understanding
the detailed morphology of the RAV and the spatial relationships between
important anatomic landmarks is crucial for the success of invasive
cardiac procedures.
Therefore, the aim of this study was to gain a better understanding of
the anatomy of the RAV and describe the spatial relationships between
selected structures of the right atrium. We hope that the collected data
will help enhance the quality and safety of cardiac surgeries and
minimally invasive procedures conducted within the RAV area.