Anatomical changes in the architectonics of the heart and great vessels that do not lead to gross impairment of the function of the cardiovascular system should be referred to small anomalies of heart development (MARS). The etiological cause of minor abnormalities of the heart, is hereditarily determined connective tissue dysplasia, which has various clinical manifestations depending on the degree of penetrance of the gene. Classification MARS is based on the principle of anatomical affiliation. There are the following MARS:
1.A very narrow aortic root. 2. Limitarily wide aortic root. 3 Bicuspid AK. 4. Asymmetry of AK flaps. 5. Replacing the AK valves.
Double-leaf AK with prolapsed cusps without regurgitation.
1. The transverse, longitudinal trabeculae (chord) in the LV cavity. 2. Systolic deformity of the outgrowth part of the IUP in the form of a roller (transient systolic roller) 3. Split, abnormally located, additional or hypertrophied papillary muscles.
1. Procuring MK (sagging 5-7 mm – Ι Art., 8-9 – ΙΙ Art., Above 9 mm – ΙΙΙeast; sagging up to 5 mm is considered a normal valve kinetics) .2. Ectopic fastening of chords to the wings of the MC.
To avoid subjectivity and subsequent overdiagnostics of MARS, their objectification is necessary, through quantitative evaluation. In cardiology practice, quantitative assessment is widely used in the study of the depth of mitral valve prolapse. Also, a quantitative approach is used in determining the length of the elongated Eustachian valve, dilatation of great vessels, atrioventricular orifices, and the number of additional trabeculae.
When it comes to referring any structural defect in the heart to MARS, it must be remembered that the principle of evaluation by functional significance is conditional. A bicuspid aortic valve usually does not lead to impaired aortic blood flow, but it is precisely with this developmental abnormality that the frequency of sudden death is higher than in the population. It is well known that whatever the tumor of the heart is: malignant, benign – it is malignant in its localization. For this reason, consideration of MARS only from the point of view of changing the structure of an organ without taking into account their effect on hemodynamic parameters and prognosis is dangerous and extremely harmful. On the other hand, the exaggeration of the functional significance of stigma in the heart is also not justified. In each case, the structural anomaly in the heart must be assessed in prognostic terms.It should also be emphasized that MARS can cause the appearance of the so-called functional heart murmurs (both systolic and diastolic).