Mitral vs Tricuspid Annulus : A quick comparative table
February 5, 2026 by dr s venkatesan
The table was gathered with content from multiple sources and few personal observations. Any doubts please check with more authentic sources. To understand fully, we need to read extensively the anatomy of the cardiac fibro-skeleton. (Saremi F, . Radiographics. 2017 )
Image source: Mitral Annulus: An Intraoperative Echocardiographic Perspective Mahmood, Feroze et al. Journal of Cardiothoracic and Vascular Anesthesia, Volume 27, Issue 6, 1355 – 1363
Final message
One important message we get is, the tricuspid annulus is more dynamic despite it being attached to a low-powered chamber. The second clinically important lesson I learned was, if the RV annulus doesn’t balance its motion corresponding to its mitral counterpart, there is a risk of developing more pulmonary congestion in a compromised heart with LV dysfunction. What can be refered to, as un- balanced Bi-Ventricular failure (The TAPSE to MAPSE ratio explains about this : Zhang H, BMC Anesthesiol. 2023 )
Postamble
After going through the reference article cited below, it is fascinating to realize the cardiac skeleton is just like a fragile fish bone hidden within the heart, to which all the vital structures, right from the muscles ,valves, and even the great arteries are attached with varying degrees of firmness. Wonder, it ever gets fractured ? may be in most degenerative heart disease like Lev’s or Lenegres.
Reference
Saremi F, Sánchez-Quintana D, Mori S, Muresian H, Spicer DE, Hassani C, Anderson RH. Fibrous Skeleton of the Heart: Anatomic Overview and Evaluation of Pathologic Conditions with CT and MR Imaging. Radiographics. 2017 Sep-Oct;37(5):1330-1351. doi: 10.1148/rg.2017170004. Epub 2017 Aug 18. PMID: 28820653.
