To date there is scarce published evidence reporting the dual blood supply reaching anterior papillary muscle (APM), which descends from both major coronary arteries. Such a vascular configuration can prevent the dysfunction of right ventricular entire valvular system in case of the occlusion of proximal part of either right coronary artery (RCA) or left coronary artery (LCA). The aim of our study was to determine the vascular pattern of APM blood supply which originates from two main coronary arteries, in the context of the APM and septomarginal trabecula (SMT) topography. The study was carried out using tissue obtained from 36 human hearts. The material was divided into four morphological types of SMT/APM arrangement. Vascularization and blood supply pattern of papillary muscle was investigated following the analysis of multiple tissue cross sections. The origin of APM arterial supply was traced back to both main coronary arteries. Cross-sectional area of the arteries was estimated at the base of APM and compared within mixed male-female population, aged 18–76. We noted that as much as 78% of entire APM material had a blood supply vasculature originating from both LCA and RCA branches. In contrast, 22% of cases APM was supplied by a single coronary artery, while in each case it proved to be LCA. We have never found APM arterial supply provided exclusively by RCA. In case of double AMP blood supply an average of total cross-section area of the arteries branching from LCA, was noted to be in excess of two and a half times bigger in type III and more than two times bigger in type IV, as compared with the arteries originating from RCA. Our research confirm the possibility of double blood supply which vascularizes APM, but the finding does not necessarily apply in all cases. However, APM seems to be predominantly vascularized by arteries deriving from LCA, regardless of their morphological type.

The right ventricular outflow tract (RVOT) is located above the supraventricular crest and reaches the level of the pulmonary valve. Detailed knowledge of the RVOT spatial structure and its morphology is extremely important for cardiac invasive therapeutic procedures. To examine the spatial structure of the RVOT using virtual models of the right ventricle (RV) interior obtained post mortem. The study was carried out using 40 adult hearts from both sexes fixed in formalin. Donors had a negative history of cardiovascular diseases. Silicone models of the interior of the RV were made and then subjected to a digital modelling procedure using the photogrammetry technique. For each 3D model of the RV, the RVOT was extracted and measurements were performed. Statistical analysis demonstrated that the dimensions of the transverse (p < 0.001) and sagittal (p = 0.002) axis at the level of the upper and lower border of the RVOT differed significantly. There was also a significant difference between the right and left height of the RVOT (p = 0.009). A clear correlation was found between the volume of the RVOT and the volume of the entire RV (r = 0.718, p < 0.001). The obtained 3D models of the RVOT can help standardize the data related to RVOT architecture. Furthermore, they can extend knowledge about the RVOT in the field of cardiology and improve the procedures in cardiac surgery.

A novel approach to visualization of the right ventricular outflow tract. Introduction: Nowadays, heart is one of the most demanding organs for imaging procedures. This is related to its irregular shape and complex intern...

The right ventricular outflow tract (RVOT) is an anatomically complex and spatially variable cardiac region that is difficult to characterise using isolated manual measurements. Although three-dimensional reconstruction techniques enable detailed visualisation of RVOT morphology, reproducible workflows for quantitative, level-based analysis of RVOT geometry remain limited. The aim of this methodological study was to develop and evaluate a semi-automated workflow for quantitative analysis of RVOT geometry based on 3D point-cloud models. This study represents a secondary methodological analysis of an existing anatomical dataset, introducing a new semi-automated workflow for systematic cross-section generation and quantitative descriptor extraction. Anatomical RVOT models were prepared from post-mortem material using silicone casting and digital photogrammetry. After point-cloud preparation, primary cross-sections were used to estimate a global directional reference. A mathematically defined inferior boundary plane and a predefined superior anatomical limit were then used to generate secondary cross-sections along the standardised RVOT segment. For each retained section, positional, ellipse-based, distance-based and area-based descriptors were extracted. The workflow was applied to 60 RVOT point-cloud models. After quality control, 661 secondary cross-sections were retained for analysis, with 5–16 sections per model and a mean of 11.02 ± 2.47 sections per model. Methodological validation included synthetic testing, comparison with manual measurements, and inter-observer assessment. Agreement with manual dimensions was high (ICC = 0.905–0.937), while inter-observer landmark variability was low (RMSE = 0.41 mm). An additional exploratory inter-observer assessment of three RVOT models yielded mean model-specific RMSE values of 12.97 mm² for cross-sectional area and 0.54 mm for both ellipse axes. The proposed workflow provides a predefined geometric framework for quantitative description of RVOT geometry and should be regarded as a methodological proof of concept rather than a clinically validated measurement system.

The right ventricular outflow tract (RVOT) exhibits complex morphology and spatial orientation, posing challenges for accurate anatomical assessment. Detailed characterization of this region has become increasingly important in interventional cardiology, where the success of lead placement and catheter ablation depends on precise knowledge of RVOT geometry. In this study, a total of 60 adult human hearts were examined and subsequently stratified into three age groups: young adults (18-40 years), middle-aged (41-60 years), and older adults (61-85 years). Silicone RVOT casts were prepared and digitized through photogrammetry to generate three-dimensional models. Secondary cross-sections were derived, and the centroids were determined. The resulting coordinates and their distances from the central RVOT axis were analyzed using a custom MATLAB algorithm. Intergroup comparisons were conducted employing appropriate statistical tests. Centroids positions varied across all age groups. Significant differences in x-coordinate values were identified only in older adults hearts (p < 0.001), reflecting greater displacements in the mid-RVOT segment. The most pronounced shifts occurred in cross-section no. 3, corresponding to the central portion of the RVOT. Deviations from the central axis demonstrated that the mid-RVOT consistently deflects away from this axis across all age groups, suggesting a rotational configuration. Age-related displacement of RVOT centroids, particularly in older individuals, may have direct implications for procedural planning in catheter ablation and device implantation. Three-dimensional modeling with spatial analysis enables high-fidelity reconstruction of RVOT anatomy, supporting individualized therapeutic strategies and potentially improving procedural outcomes.

Cardiovascular diseases remain the leading cause of mortality worldwide and continue to impose a substantial clinical burden despite major advances in pharmacological and interventional therapies. Because the adult myocardium has limited regenerative capacity, irreversible cardiomyocyte loss frequently leads to adverse remodeling and progressive heart failure (HF). Mesenchymal stromal cells (MSCs) are among the most extensively studied cell therapies for cardiac repair because of their immunomodulatory, pro-angiogenic, anti-inflammatory, and anti-fibrotic effects, mediated predominantly through paracrine signaling. This review summarizes the current evidence for MSC-based therapy in ischemic heart disease (IHD), coronary and microvascular disorders, myocardial infarction, HF, myocarditis, pulmonary arterial hypertension, and valvular heart disease (VHD). We discuss MSC sources, preclinical and clinical evidence, manufacturing and dosing, delivery routes, biomaterial-assisted transplantation, preconditioning, genetic modification, and imaging for cell tracking and treatment monitoring. Although MSC therapy has shown a favorable safety profile and regenerative potential, clinical efficacy remains variable because of limited cell survival, poor myocardial retention, and heterogeneous treatment protocols. Further optimization of manufacturing, delivery, and patient selection, together with well-designed randomized trials, is required to establish standardized protocols and support clinical translation.