Smooth muscle cells in the cusps of the aortic valve of pigs

Heart valve macro- and microstructure

Each heart valve is composed of different structures of which each one has its own histological profile. Although the aortic and the pulmonary valves as well as the mitral and the tricuspid valves show similarities in their architecture, they are individually designed to ensure optimal function with regard to their role in the cardiac cycle. In this article, we systematically describe the structural elements of the four heart valves by different anatomical, light- and electron-microscopic techniques that have been presented. Without the demand of completeness, we describe main structural features that are in our opinion of importance in understanding heart valve performance. These features will also have important implications in the treatment of heart valve disease. They will increase the knowledge in the design of valve substitutes or partial substitutes and may participate to improve reconstructive techniques. In addition, understanding heart valve macro- and microstructure may also be of benefit in heart valve engineering techniques.

Presence of a smooth muscle system in aortic valve leaflets

The location and the spatial arrangement of smooth muscle cells in aortic valves have been assessed by a systematic analysis of serial semithin sections of plastic embedded porcine and human aortic leaflets, combined with an electron microscope study. The investigation showed that smooth muscle cells, either single and arranged in thin bundles, and other cell types such as myofibroblasts are constantly present in the aortic valve leaflets. In addition, it was possible to devise a model of the three dimensional, specific organization of the smooth muscle bundles which can be interpreted as an intrinsic muscle system of the leaflets. As the muscular elements might play an active role in the normal functioning of the valve, their presence should be taken into account in designing (bio)prosthetic leaflets and in the evaluation of valve pathology.