Anatomy of the heart left ventricle

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Assistant Editor(s)-in-Chief: Rim Halaby, Yazan Daaboul

Overview

Left ventricle comprises the bulk of the myocardium and receives oxygenated blood from the left atrium through the mitral valve and pumps the same blood into the aorta via the aortic valve.

Left Ventricle

• The left ventricle is characterized by its thick muscular wall that covered by more numerous trabeculae carneae than in the right ventricle.
• Muscularization of the left ventricle grants it a sufficient work performance to pump blood appropriately to the systemic circulation and to feed all vascular beds.

Mitral (Bicuspid) Valve

• The left ventricle contains the mitral valve at the level of the AV orifice. The mitral valve is located substernally at the fourth sternocostal junction.
• It is composed of 2 cusps: anterior and posterior.
• The mitral valve is attached to the left ventricle by two papillary muscles: anterior and posterior, each giving rise to tendinous cords to both cusps simultaneously.
• Although functionally similar to the papillary muscles in the right ventricle, the anterior and posterior papillary muscles in the left ventricle are anatomically larger.

Aortic Vestibule

• The aortic vestibule is a supero-anterior component of the left ventricle that delineates the left ventricle’s outflow tract.
• In contrast to the muscular component of the left ventricle, the aortic vestibule is fibrous smooth-walled structure that is non-muscular.
• At the end of the aortic vestibule in its right postero-superior part lies an oblique aortic valve and the aortic orifice, the beginning of the ascending aorta.

Aortic (Semilunar) Valve

• The left ventricle and the aortic orifice are separated by the aortic valve.
• It is located substernally near the left sterno-costal junction.
• Similar to other valves in the heart, the aortic valve is surrounded by a fibrous ring that allows the three valve cusps to attach to.
• The three aortic valve semilunar cusps are named according to their position: right, posterior, and left.

Aortic Sinuses

• Aortic sinuses are bulges at the base of the ascending aorta between its wall and the aortic valve cusps that give rise to the coronary arteries, the arteries that supply the myocardium with oxygen and nutritional demands.
• The right aortic sinus is associated to the right coronary artery; the left aortic sinus is associated to the left coronary artery, while the posterior aortic sinus is not associated with any coronary artery. Thus it is called the non-coronary sinus.

References

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