Abstract
To understand mitral valve dysfunction the anatomy of the valve must be understood. The mitral valve is an atrioventricular valve with leaflets and chordae that attach to papillary muscles. There are two leaflets: the anterior and the posterior (Fig. 4.1). On either side of the leaflets there are commissures. The mitral valve has no septal chordal attachments. The anterior leaflet is in fibrous continuity with the aortic valve (Fig. 4.2). The leaflets have free edges and closing margins, approximately a few mm from the edge. The mitral valve annulus is better defined than the right sided annulus, and a fibrous annular band can be grossly seen. The posterior leaflet has three scallops that are discernible and formed to varying degrees. These small indentations allow redundancy to the valve, which is important for leaflet overlap and competency.
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References
Luetmer PH, Edwards WD, Seward JB, Tajik AJ. Incidence and distribution of left ventricular false tendons: an autopsy study of 483 normal human hearts. J Am Coll Cardiol. 1986 July;8(1):179-183.
Rullan E, Sigal LH. Rheumatic fever. Curr Rheumatol Rep. 2001;3:445-452.
Cunningham MW. T cell mimicry in inflammatory heart disease. Mol Immunol. 2004 Feb;40(14–15):1121-1127.
Hilario MO, Terreri MT. Rheumatic fever and post-streptococcal arthritis. Best Pract Res Clin Rheumatol. 2002 July;16(3):481-494.
Olivier C. Rheumatic fever – is it still a problem? J Antimicrob Chemother. 2000 Feb 1;45(90001):13-21.
Stollerman GH. Rheumatic fever in the 21st century. Clin Infect Dis. 2001 Sept 15;33(6):806-814.
Cunningham MW. Autoimmunity and molecular mimicry in the pathogenesis of post-Streptococcal heart disease. Frontiers in Biosci. 2003;8:s533-s545.
Guilherme L, Cury P, Demarchi LMF, et al. Rheumatic heart disease: proinflammatory cytokines play a role in the progression and maintenance of valvular lesions. Am J Pathol. 2004 Nov 1;165(5):1583-1591.
Roberto S, Kosanke S, Dunn ST, Jankelow D, Duran CMG, Cunningham MW. Pathogenic mechanisms in rheumatic carditis: focus on valvular endothelium. J Infect Dis. 2001;183:507-511.
Anwar AM, Attia WM, Nosir YF, et al. Validation of a new score for the assessment of mitral stenosis using real-time three-dimensional echocardiography. J Am Soc Echocardiogr. 2010 Jan;23(1):13-22.
Hauck AJ, Edwards WD, Danielson GK, Mullany CJ, Bresnahan DR. Mitral and aortic valve disease associated with ergotamine therapy for migraine. Arch Pathol Lab Med. 1990;114:62-4.
Redfield MM, Nicholson WJ, Edwards WD, Tajik AJ. Valve disease associated with ergot alkaloid use: echocardiographic and pathologic correlations. Ann Intern Med. 1992;117:50-52.
Wilkins GT, Weyman AE, Abascal VM, Block PC, Palacios IF. Percutaneous balloon dilatation of the mitral valve: an analysis of echocardiographic variables related to outcome and the mechanism of dilatation. Br Heart J. 1988 Oct;60(4):299-308.
Faletra F, Pezzano A Jr, Fusco R, et al. Measurement of mitral valve area in mitral stenosis: four echocardiographic methods compared with direct measurement of anatomic orifices. J Am Coll Cardiol. 1996 Nov 1;28(5):1190-1197.
Connolly HM, Crary JL, McGoon MD, et al. Valvular heart disease associated with fenfluramine-phentermine. N Engl J Med. 1997 Aug 28;337(9):581-588.
Sachdev M, Miller WC, Ryan T, Jollis JG. Effect of fenfluramine-derivative diet pills on cardiac valves: a meta-analysis of observational studies. Am Heart J. 2002 Dec;144(6):1065-1073.
Kimmel SE, Keane MG, Crary JL, et al. Detailed examination of fenfluramine-phentermine users with valve abnormalities identified in Fargo, North Dakota. Am J Cardiol. 1999 Aug 1;84(3):304-308.
Steffee CH, Singh HK, Chitwood WR. Histologic changes in three explanted native cardiac valves following use of fenfluramines. Cardiovasc Pathol. 1999 Sep;8(5):245-253.
Volmar KE, Hutchins GM. Aortic and mitral fenfluramine-phentermine valvulopathy in 64 patients treated with anorectic agents. Arch Pathol Lab Med. 2001 Dec;125(12):1555-1561.
Pritchett AM, Morrison JF, Edwards WD, Schaff HV, Connolly HM, Espinosa RE. Valvular heart disease in patients taking Pergolide. Mayo Clin Proc. 2002;77:1280-1286.
Hong ZG, Smith AJ, Archer SL, et al. Pergolide is an inhibitor of voltage-gated potassium channels, including Kv1.5, and causes pulmonary vasoconstriction. Circulation. 2005;112(10):1494-1499.
Sia YT, Dulay D, Burwash IG, Beauchesne LM, Ascah K, Chan KL. Mobile ventricular thrombus arising from the mitral annulus in patients with dense mitral annular calcification. Eur J Echocardiogr. 2010;11:198-201.
Zoghbi WA, Enriquez-Sarano M, Foster E, et al. RecommenÂdations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003 Jul;16(7):777-802.
Hynes MS, Tam JL, Burwash IG, Chan KL. Predictive value of pulmonary venous flow patterns in detecting mitral regurgitation and left ventricular abnormalities. Can J Cardiol. 1999 June;15(6):665-670.
Salehian O, Chan KL. Impact of three-dimensional echocardiography in valvular heart disease. Curr Opin Cardiol. 2005 Mar;20(2):122-126.
Zamorano J, Perez DI, Sugeng L, et al. Non-invasive assessment of mitral valve area during percutaneous balloon mitral valvuloplasty: role of real-time 3D echocardiography. Eur Heart J. 2004 Dec;25(23):2086-2091.
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Chan, KL., Veinot, J.P. (2010). Mitral Valve. In: Anatomic Basis of Echocardiographic Diagnosis. Springer, London. https://doi.org/10.1007/978-1-84996-387-9_4
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