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The chordae tendineae (sg.: chorda tendinea) or tendinous cords, colloquially known as the heart strings, are inelastic cords of fibrous connective tissue that connect the papillary muscles to the tricuspid valve and the mitral valve in the heart.
The papillary muscles are muscles located in the ventricles of the heart. They attach to the cusps of the atrioventricular valves (also known as the mitral and tricuspid valves) via the chordae tendineae and contract to prevent inversion or prolapse of these valves on systole (or ventricular contraction).
Parachute mitral valve occurs when all chordae tendineae of the mitral valve are abnormally attached to a single (or fused) papillary muscle. Straddling Mitral Valve occurs when the mitral valve's chordal attachments straddles, or goes through, a ventricular septal defect (VSD) and so has chordae originating on both sides of the ventricular ...
The papillary muscles extend from the walls of the heart to valves by cartilaginous connections called chordae tendinae. These muscles prevent the valves from falling too far back when they close. [24] During the relaxation phase of the cardiac cycle, the papillary muscles are also relaxed and the tension on the chordae tendineae is slight.
They are anchored to the walls of the ventricles by chordae tendineae, which prevent them from inverting. The chordae tendineae are attached to papillary muscles that cause tension to better hold the valve. Together, the papillary muscles and the chordae tendineae are known as the subvalvular apparatus.
As the left posterior fascicle is shorter and broader than the right, impulses reach the papillary muscles just prior to depolarization, and therefore contraction, of the left ventricle myocardium. This allows pre-tensioning of the chordae tendinae, increasing the resistance to flow through the mitral valve during left ventricular contraction. [5]
Chordae tendineae are attached to the ventricular surfaces and the free edges of the two leaflets. Chordae are also attached to the two papillary muscles of left ventricle. Anterior leaflet is much larger than the posterior leaflet but posterior has a broader base, approaching two thirds of circumflex [36]
In acute MR secondary to a mechanical defect in the heart (i.e., rupture of a papillary muscle or chordae tendineae), the treatment of choice is mitral valve surgery. If the patient is hypotensive prior to the surgical procedure, an intra-aortic balloon pump may be placed in order to improve perfusion of the organs and to decrease the degree of MR.