International Journal of Anatomy and Research

Welcome to International Journal of Anatomy and Research




Type of Article: Original Research

Year: 2016 | Volume 4 | Issue 2 | Page No. 2285-2293

Date of Publication: 31-05-2016



Bhagya Shree *1, Rajan Kumar Singla 2, Ravi Kant Sharma 3, Ashwini Kumar 4.


*1 Senior Tutor, Department of Anatomy, Guru Gobind Singh Medical College, Faridkot, Punjab, India.

2 Professor and Head, Department of Anatomy, Govt. Medical College, Patiala, Punjab, India.

3 Professor and Head, Department of Anatomy, Govt. Medical College, Amritsar, Punjab, India.

4 Assistant Professor, Department of Forensic Medicine, Guru Gobind Singh Medical College, Faridkot, Punjab, India.

Address: Dr. Bhagya Shree, Senior Tutor, Department of Anatomy, Guru Gobind Singh Medical College, Faridkot, Punjab, India.


Introduction: Normal valve function depends upon the anatomic and mechanical integrity of the atrioventricular ring, the valve leaflets, the chordae tendineae and papillary muscles. Papillary muscle rupture and dysfunction can lead to complications of prolapsed mitral valve and mitral regurgitation.
Materials and Methods: The material for present study consisted of 50 formalin fixed adult apparently normal cadaveric hearts belonging to either sex obtained from the Department of Anatomy, Govt. Medical College, Amritsar. These hearts were dissected to open the left ventricle and to expose the papillary muscles. Different morphological features of papillary muscles were noted and measurements were taken.
Results: The anterolateral papillary muscle usually said to be single bellied was found so in majority of the hearts (86%) being double bellied in the rest of 14% hearts. However, the posteromedial papillary muscle usually said to be double bellied was found so only in 56% of the hearts, being 3 bellied in 20%, 4 bellied in 10% & single bellied in 14%. Negligible text is available about the number of heads of papillary muscles. It varied from 1- 6 and 1- 5 in anterolateral & posteromedial papillary muscles respectively which is another notable variation. Different shapes and pattern of papillary muscles have also been identified. An additional divison of study was measurement of lengths of papillary muscles which thus provides a base line data for further detailed studies based upon a larger data base.
Conclusion: In this study, observations of more number of bellies of anterolateral papillary muscle and posteromedial papillary muscle instead of the only twos, are important and demand a modification in standard textbooks of anatomy. Notable variations of papillary muscles are important for scientists worldwide in order to ascertain the reason behind each specific architechtural arrangement. This will enable the cardio thoracic surgeons to tailor the surgical procedures according to the individual papillary muscle pattern.
Key Words: Papillary muscles, left ventricle, mitral valve, Heart.


  1. Gunnal SA, Wabale RN, Farooqui MS. Morphological variations of papillary muscles in the mitral valve complex in human cadaveric hearts. Singapore Med J 2013; 54(1):44-8.

  2. Gabella G. Cardiovascular system. In: Williams PL, Bannister LH, Berry MM, Collins P, Dyson M, Dussek JE et al editors. Gray’s Anatomy, The Anatomical basis of Medicine and Surgery. 38th ed. Philadelphia, London: Churchill Livingstone; 1995. p.1472-87.

  3.  Burch GE, DePasquale NP, Phillips JH. The syndrome of papillary muscle dysfunction. Am Heart J 1968;75(3):399-415.

  4.  Mittal AK, Langston M, Cohn KE, Selzer A, Kerth WJ. Combined papillary muscle and left ventricular wall dysfunction as a cause of mitral regurgitation. Circulation 1971;44:174-80.

  5.  Perloff JK, Roberts WC. The mitral apparatus. Functional Anatomy of mitral regurgitation. Circulation 1972;46:227-39.

  6.  Brock RC. The surgical and pathological anatomy of the mitral valve. Br Heart J 1952; 14:489-513.

  7. Walmsley T. The heart. In: Sharpey, Sharpey-Schafer E, Symington J, Bryce TH editors. Quain’s elements of anatomy. 11th ed. London: Langmans, Green & Co; 1929: p. 42.

  8. Roberts WC, Cohen LS. Left ventricular papillary muscles. Description of the normal and a survey of conditions causing them to be abnormal. Circulation 1972;46:138-54.

  9.  Victor S, Nayak VM. Variations in the papillary muscles of the normal mitral valve and their surgical relevance. J Card Surg 1995;10(5):597-607.

  10.  Rusted IE, Schiefley CH, Edwards JE. Guides to the commissures in operations upon the mitral valve. Proc Staff Meet, Mayo Clin 1951;26:297.

  11.  Ranganathan N, Burch GE. Gross morphology and arterial supply of the papillary muscles of left ventricle of man. Am Heart J 1969;77(4):506-16.

  12.  Gatzoulis MA. Thorax. In: Standring S, Borley NR, Collins P, Crossman AR, Gatzoulis MA, Healy JC et al editors. Gray’s Anatomy, The Anatomical basis of Medicine and Surgery. 40th ed. Elsevier: Churchill Livingstone; 2008: p.907-1013.

  13.  Kanjanathaui S, Sharma GK, Lange RA. Mitral valve anatomy. [online] 2011 Aug16  [cited 2012 Mar 17]; Available from 1878301.

  14. Oosthoek PW, Wenink AC, Wisse Lj, Gittenberger- de Groot AC. Development of the papillary muscles of the mitral valve: morphogeneticbackground of parachute –like asymmetric mitral valves and other mitral valve anomalies. J Thorac Cardiovasc Surg 1998;116:36-46.

  15.  Madu EC, D’Cruz IA. The vital role of papillary muscles in mitral and ventricular function: echocardiographic insights. Clin Cardiol 1997;20:93-8.

  16.  Shone JD, Sellers RD, Anderson RC, Adams P, Lillehei CW, Edwards JE. The developmental complex of “parachute mitral valve”, supravalvular ring of left atrium, subaortic stenosis and coarctation of aorta. The Am J Cardiol 1963;714-24.

  17.  Glancy DL, Chang MY, Dorney ER, Roberts WC. Parachute mitral valve. Further observations and associated lesions. Am J Cardiol 1971;27:309.

  18. Carney EK, Braunwald E, Roberts WC, Aygen M, Morrow AG. Congenital mitral regurgitation: Clinical hemodynamic and angio-cardiographic findings in nine patients. Am J Med 1962;33:223.

  19. Davachi F, Moller JH, Edwards JE. Diseases of the mitral valve in infancy: An anatomic analysis of 55 cases. Circulation 1971;43:565.

  20. Castaneda AR, Anderson RC, Edwards JE. Congenital mitral stenosis resulting from anomalous arcade and obstructing papillary muscles: Report of correction by use of ball valve prosthesis. Am J Cardiol 1969;24:237.

  21. Levy MJ, Edwards JE. Anatomy of mitral insufficiency. Progr Cardiovasc Dis. 1962;5: 119.

  22. Ranganathan N, Lam JHC, Wigle ED, Silver MD. Morphology of the human mitral valve. II. The valve leaflets. Circulation 1970;41:459-67.

  23.  Klues HG, Roberts WC, Maron BJ. Anomalous insertion of papillary muscle directly into anterior mitral leaflet in hypertrophic cardiomyopathy: significance in producing left ventricular outflow obstruction. Circulation 1991;84:1188-97.

  24. Ohkado A, Kitamura M, Hachida M, Nishinaka T, Hanayama N, SatoW, et al. Hypertrophic obstructive cardiomyopathy with abnormalities of the mitral valve complex. J Heart Valve Dis 1997;6(1):60–2.

  25. Bryant R 3rd, Smedira NG. Papillary muscle realignment for symptomatic left ventricular outflow obstruction. J Thorac Cardiovasc Surg 2008;135:223-4.

  26.  Yousefnia MA, Mandegar MH, Roshanali F, Alaeddini F, Amouzadeh F. Papillary muscles repositioning in mitral valve replacement in patients with left ventricular dysfunction. Ann Thorac Surg 2007;83:958-63.

  27. Hosapatna M, D Souza A, Das AM, Supriya, Ankolekar VH, D Souza AS. Morphology of Papillary Muscles in Human Adults: A Cadaveric Study. Ibnosina J Med BS;2014:168- 72.

  28. Ross DN. Historical perspective of surgery on the mitral valve. In: Duran C, Angell NW, Johnson AD, et al editors. Recent progress in mitral valve disease. London, Butterworth & Co., Ltd.; 1984:p.5- 12.


Bhagya Shree, Rajan Kumar Singla, Ravi Kant Sharma, Ashwini Kumar. A STUDY OF PAPILLARY MUSCLES OF THE LEFT VENTRICLE IN THE ADULT HUMAN CADAVERS. Int J Anat Res 2016;4(2):2285-2293. DOI: 10.16965/ijar.2016.197




Volume 1 (2013)

Volume 2 (2014)

Volume 3 (2015)

Volume 4 (2016)

Submit Manuscript