[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Anatomy](https://durgical.com/en/anatomy/) › [Chest](https://durgical.com/en/anatomy/region/chest/) › Chordae tendineae

[Cardiovascular system](https://durgical.com/en/anatomy/system/cardiovascular-system/) · [Chest](https://durgical.com/en/anatomy/region/chest/)

# Chordae tendineae

The chordae tendineae are thin cords inside the ventricles that tie the valve flaps to muscle, stopping them flipping back when the heart squeezes.

Official name: Chordae tendineae of right atrioventricular valve

[See in 3D →](https://durgical.app/?from=durgipedia&lang=en#region=thorax&select=chordae_tendineae&side=r)

Opens in the Durgical app, no sign-up needed.

## What it is

Thin, strong cords like parachute strings joining the edges of the mitral and tricuspid leaflets to the papillary muscles.

## What it does

Stop the leaflets from flipping back into the atria when the ventricles squeeze.

## Key points

- First-order chordae reach the free edge and stop prolapse; second-order chordae (including the strong strut chords) reach the ventricular surface; third-order arise from the wall
- Rupture (degeneration, endocarditis, trauma) leaves a flail leaflet and sudden severe regurgitation with lung edema
- Keeping the chordae during mitral valve replacement helps preserve left ventricular shape and function

## Key facts

**Where**
Fibrous cords in both ventricles

**Attaches**
Papillary muscles (and RV septum) to free edges and ventricular surfaces of tricuspid and mitral leaflets

**Function**
Prevent AV leaflets from everting into atria during systole; rupture causes acute regurgitation

## Relations

**Above**
Leaflets: each papillary muscle sends cords to the neighbouring halves of two leaflets, so it holds both sides of one commissure

**Below**
Tips of the [left ventricle papillary muscles](https://durgical.com/en/anatomy/superior-papillary-muscle-of-left-ventricle/) and [right ventricle papillary muscles](https://durgical.com/en/anatomy/papillary-muscles-of-right-ventricle/); on the right some arise straight from the septum

## How to find it

In a dissection, opening the ventricle and lifting a leaflet shows the cords fanning out from the papillary tips to the free edge and underside of the leaflet; the two thick strut chords sit on the ventricular face of the anterior mitral leaflet.

## On imaging

Echocardiography shows them as fine lines; a ruptured chord appears as a mobile strand whipping into the atrium in systole (flail), best on transesophageal echo. Vegetations may hang from them in endocarditis.

## Common problems

- A torn chord makes a leaflet flail and the valve leak suddenly, causing sudden breathlessness.

## How it is diagnosed

Echocardiogram.

## Treatment

- Surgical repair: resecting the floppy segment or adding artificial chords.

## Clinical notes

- Repair replaces torn chordae with artificial cords or transfers healthy ones
- Rheumatic disease thickens, shortens and fuses the chordae, adding narrowing below the valve and making balloon commissurotomy less suitable

## Development

They form with the papillary muscles as the ventricular wall is hollowed out: strands of muscle become fibrous cords.

## Related conditions

- [Mitral valve prolapse](https://durgical.com/en/conditions/mitral-valve-prolapse/)
- [Rheumatic heart disease](https://durgical.com/en/conditions/rheumatic-heart-disease/)
- [Mitral regurgitation](https://durgical.com/en/conditions/mitral-regurgitation/)

## Test yourself

Think of the answer, then tap the question to see it.

## How are chordae tendineae classified by where they attach?

First-order reach the free edge and stop prolapse; second-order (including strut chords) reach the ventricular surface; third-order arise from the wall.

## What happens when chordae tendineae rupture?

The leaflet becomes flail, with sudden severe regurgitation and lung edema.

## Why are the chordae tendineae kept during mitral valve replacement?

Keeping them helps preserve the shape and function of the left ventricle.

## How does rheumatic disease change the chordae tendineae?

It thickens, shortens and fuses them, adding narrowing below the valve and making balloon commissurotomy less suitable.

[Add to my cards (4)](https://durgical.app/estudiar/?add=/en/anatomy/chordae-tendineae-of-right-atrioventricular-valve/)

Educational information, not medical advice. For any symptom, see a health professional.

## Its names

**Official Latin (TA2)**
chordae tendineae valvae atrioventricularis dextrae; chordae tendineae valvae atrioventricularis sinistrae TA2 4047

**Official Spanish (DeCS)**
Cuerdas tendinosas DeCS D002815

**English (TA2)**
Chordae tendineae of right atrioventricular valve

**Also called**
tendinous cords of right atrioventricular valve · tendinous cords of left atrioventricular valve · tricuspid chordae tendineae

## Related

- [Left ventricle papillary muscles](https://durgical.com/en/anatomy/superior-papillary-muscle-of-left-ventricle/)
- [Mitral posterior leaflet](https://durgical.com/en/anatomy/posterior-leaflet-of-left-atrioventricular-valve/)

Sources: Terminologia Anatomica (TA2); [DeCS](https://decs.bvsalud.org/es/ths/resource/?id=2866&filter=ths_termall&q=Cuerdas%20Tendinosas); [Anatomy, Thorax, Heart Papillary Muscles](https://www.ncbi.nlm.nih.gov/books/NBK557802/).

## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake

Representative model, for educational purposes only.

---
Source: https://durgical.com/en/anatomy/chordae-tendineae-of-right-atrioventricular-valve/
License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/anatomy/chordae-tendineae-of-right-atrioventricular-valve/