 Cardiac valve annulus

A cardiac valve annulus is the supporting attachment region around a heart valve's opening, used as an anatomical and imaging reference for its valve leaflets. The term should be interpreted for the particular valve: the mitral annulus and the operational reference geometry of the aortic annulus are not interchangeable structures. An annulus is not necessarily a rigid, flat circle.

The three-dimensional shape matters experimentally. A primary study mounted eleven human specimens of the mitral valve in a left-heart simulator with adjustable flat or saddle-shaped annular configurations. In selected experiments, transducers recorded chordae tendineae forces.^[ref] The shape comparison redistributed chordal forces, showing that a two-dimensional diameter alone does not describe the full supporting geometry.

An original area example separates two common geometric descriptors. An ellipse with semiaxes $a=20$ mm and $b=10$ mm has area $\pi ab=200\pi$ mm${}^2$. A circle of radius $\sqrt{200}$ mm has the same area, but its diameter is about 28.3 mm rather than the ellipse's 40 mm major diameter. An equal area therefore does not determine the width a leaflet must span in every direction.

A further three-dimensional model can retain the same projected outline while varying attachment heights:Changing $h$ leaves the projected ellipse unchanged but changes the spatial boundary. This is a schematic saddle-like curve, not a complete anatomical model. It illustrates why measurements of projected area, diameter and height can carry different information. The relation between annular geometry, leaflet deformation and coaptation must be assessed with consistent valve-specific landmarks and phases.