Skip to main content
SpringerLink
Log in
Book cover

Mitral Valve Surgery pp 31–42Cite as

Chronic Mitral Regurgitation

  • Chapter
  • First Online:

  • 1386 Accesses

Abstract

The mitral valve is a complex, bi-leaflet structure that separates the left atrium (LA) and the left ventricle (LV). It consists of two leaflets, a fibrous annulus, chordae tendinae, two papillary muscles, and their left ventricular attachments (Fig. 3.1).

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   129.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Perloff JK, Roberts WC. The mitral apparatus – functional anatomy of mitral regurgitation. Circulation. 1972;46:227-239.

    CAS  PubMed  Google Scholar 

  2. Carpentier AF, Lessana A, Relland J, et al. The “Physio-Ring”: an advanced concept in mitral valve annuloplasty. Ann Thorac Surg. 1995;60:1177-1186.

    Article  CAS  PubMed  Google Scholar 

  3. Lam JHC, Ranganathan N, Wigle ED, Silver MD. Morphology of the human heart valve I. Chordae tendinae: a new classification. Circulation. 1970;41:449-458.

    CAS  PubMed  Google Scholar 

  4. Rusted IE, Schiefly CH, Edwards JE. Studies of the mitral valve. I. Anatomical features of the normal mitral valve and associated structures. Circulation. 1952;6:825-831.

    CAS  PubMed  Google Scholar 

  5. Voci P, Bilotta F, Caretta Q, Mercanti C, Marino B. Papillary muscle perfusion pattern: a hypothesis for ischemic papillary muscle dysfunction. Circulation. 1995;91:1714-1718.

    CAS  PubMed  Google Scholar 

  6. Carpentier A. Cardiac valve surgery – the “French” correction. J Thorac Cardiovasc Surg. 1983;86:323-337.

    CAS  PubMed  Google Scholar 

  7. Schwammenthal E, Chen C, Benning E, Block E, Breithardt G, Levine RA. Dynamics of mitral regurgitant flow and orifice area: physiologic application of the proximal flow convergence method. Circulation. 1994;90:307-322.

    CAS  PubMed  Google Scholar 

  8. Gaasch W, Meyer T. Left ventricular response to mitral regurgitation: implications for management. Circulation. 2008;118:2298-2303.

    Article  PubMed  Google Scholar 

  9. Janicki JS, Brower GL, Gardner JD, et al. Cardiac mast cell regulation of matrix metalloproteinase-related ventricular remodeling in chronic pressure or volume overload. Cardiovasc Res. 2006;69:657-665.

    Article  CAS  PubMed  Google Scholar 

  10. Grossman W, Jones D, McLaurin LP. Wall stress and patterns of hypertrophy in the human left ventricule. J Clin Invest. 1975;56:56-64.

    Article  CAS  PubMed  Google Scholar 

  11. Carabello BA. Mitral regurgitation: basic pathophysiologic principles. Mod Concepts Cardiovasc Dis. 1988;57:53-58.

    Google Scholar 

  12. Detaint D, Messika-Zeitoun D, Avierinos JF, et al. B-Type Natriuretic Peptide in organic mitral regurgitation. Determinants and impact on outcome. Circulation. 2005; 111:2391-2397.

    Article  CAS  PubMed  Google Scholar 

  13. Enriquez-Sarano M, Basmadjan AJ, Rossi A. Progression of mitral regurgitation: a prospective Doppler echocardiographic study. J Am Coll Cardiol. 1999;34:1137-1144.

    Article  CAS  PubMed  Google Scholar 

  14. Iung B, Baron G, Butchaert EG, et al. A prospective survey of patients with valvular heart disease: the euro heart survey on valvular heart disease. Eur Heart J. 2003;24:1231-1243.

    Article  PubMed  Google Scholar 

  15. Singh JP, Evans JC, Levy D, et al. Prevalence and clinical determinants of mitral, tricuspid and aortic regurgitation. Am J Cardiol. 1999;83:897-902.

    Article  CAS  PubMed  Google Scholar 

  16. Jones EC, Devereux RB, Roman MJ, et al. Prevalence and correlates of mitral regurgitation in a population-based sample (the Strong Heart study). Am J Cardiol. 2001; 87:298-304.

    Article  CAS  PubMed  Google Scholar 

  17. Flack JM, Kvasnicka JH, Gardin JM, et al. Anthropometric and physiologic correlates of mitral valve prolapse in a biethnic cohort of young adults: the CARDIA study. Am Heart J. 1999;138:486-492.

    Article  CAS  PubMed  Google Scholar 

  18. Freed LA, Levy D, Levine RA, et al. Prevalence and clinical outcome of mitral valve prolapse. N Engl J Med. 1999; 341:1-7.

    Article  CAS  PubMed  Google Scholar 

  19. Desjardins VA, Enriquez-Sarano M, Tajik AJ, et al. Intensity of murmurs correlates with severity of valvular regurgitation. Am J Med. 1996;100:149-156.

    Article  CAS  PubMed  Google Scholar 

  20. Bonow RO, Carabello BA, Chatterjee K, et al. ACC/AHA 2006 guidelines for the management of patients with valvular heart disease. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol. 2006;48:e1.

    Article  PubMed  Google Scholar 

  21. Enriquez-Sarano M, Freeman WK, Tribouilloy CM, et al. Functional anatomy of mitral regurgitation: accuracy and outcome implications of transoesophageal echocardiography. J Am Coll Cardiol. 1999;34:1129-1136.

    Article  CAS  PubMed  Google Scholar 

  22. Zoghbi WA, Enriquez-Sarano M, Foster E, et al. American Society of Echocardiography. Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr. 2003;16:777-802.

    Article  PubMed  Google Scholar 

  23. Pouleur AC, le Polain de Waroux JB, et al. Usefulness of 40-slice multidetector row computed tomography to detect coronary disease in patients prior to cardiac valve surgery. Eur Radiol. 2007;17:3199-207.

    Article  PubMed  Google Scholar 

  24. Allen H, Harris A, Leatham A. Significance and prognosis of an isolated late systolic murmur: a 9 to 22 year follow up. Br Heart J. 1974;36:525-532.

    Article  CAS  PubMed  Google Scholar 

  25. Mills P, Rose J, Hollingsworth J, et al. Long-term prognosis of mitral-valve prolapse. N Engl J Med. 1977;297:13-18.

    Article  CAS  PubMed  Google Scholar 

  26. Avierinos JF, Gersh BJ, Melton LJ, et al. Natural history of asymptomatic mitral valve prolapse in the community. Circulation. 2002;106:1355-1361.

    Article  PubMed  Google Scholar 

  27. Zuppiroli A, Rinaldi M, Kramer-Fox R, et al. Natural history of mitral valve prolapse. Am J Cardiol. 1995;75:1028-1032.

    Article  CAS  PubMed  Google Scholar 

  28. Kim S, Kuroda T, Nishinaga M, et al. Relationship between severity of mitral regurgitation and prognosis of mitral valve prolapse: echocardiographic follow-up study. Am Heart J. 1996;132:348-355.

    Article  CAS  PubMed  Google Scholar 

  29. Grigioni F, Avierinos JF, Ling LH, et al. Atrial fibrillation complicating the course of degenerative mitral regurgitation: determinants and long-term outcome. J Am Coll Cardiol. 2002;40:84-92.

    Article  PubMed  Google Scholar 

  30. Ling LH, Enriquez-Sarano M, Seward JB, et al. Early surgery in patients with mitral regurgitation due to flail leaflets. A long-term outcome study. Circulation. 1997;96:1819-1825.

    CAS  PubMed  Google Scholar 

  31. Ling LH, Enriquez-Sarano M, Seward JB, et al. Clinical outcome of mitral regurgitation due to flail leaflet. N Engl J Med. 1996;335:1417-1423.

    Article  CAS  PubMed  Google Scholar 

  32. Tanaka K, Ohtaki E, Matsumura T, et al. Impact of a preoperative mitral regurgitation scoring system on outcome of surgical repair for mitral valve prolapse. Am J Cardiol. 2003;92:1306-1309.

    Article  PubMed  Google Scholar 

  33. Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al. Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med. 2005;352:875-883.

    Article  CAS  PubMed  Google Scholar 

  34. Boudoulas H, Schaal SF, Stang JM, et al. Mitral valve prolapse: cardiac arrest with long-term survival. Int J Cardiol. 1990;26:37-44.

    Article  CAS  PubMed  Google Scholar 

  35. Grigioni F, Enriquez-Sarano M, Ling LH, et al. Sudden death due to mitral regurgitation due to flail leaflet. J Am Coll Cardiol. 1999;34:2078-2085.

    Article  CAS  PubMed  Google Scholar 

  36. Kligfield P, Levy D, Devereux RB, et al. Arrhythmias and sudden death in mitral valve prolapse. Am Heart J. 1987; 113:1298-1307.

    Article  CAS  PubMed  Google Scholar 

  37. Kligfield P, Devereux RB. Is the mitral valve prolapse patient at high risk of sudden death identifiable? Cardiovasc Clin. 1990;21:143-157.

    CAS  PubMed  Google Scholar 

  38. Alpert JS. Association between arrhythmias and mitral valve prolapse. Arch Intern Med. 1984;144:2333-2334.

    Article  CAS  PubMed  Google Scholar 

  39. Vahanian A, Baumgartner H, Bax J, et al. Guidelines on the management of valvular heart disease: The Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J. 2007;28:230-268.

    PubMed  Google Scholar 

  40. Tribouilloy CM, Enriquez-Sarano M, Schaff HV, et al. Impact of preoperative symptoms on survival after surgical correction of organic mitral regurgitation: rationale for optimizing surgical indications. Circulation. 1999;99:400-405.

    CAS  PubMed  Google Scholar 

  41. Enriquez-Sarano M, Tajik AJ, Schaff HV, et al. Echocardiographic prediction of survival after surgical correction of organic mitral regurgitation. Circulation. 1994; 90:830-837.

    CAS  PubMed  Google Scholar 

  42. STS database 1997.

    Google Scholar 

  43. Savage EB, Ferguson TB, DiSesa VJ. Use of mitral valve repair: analysis of contemporary United States experience reported to the Society of Thoracic Surgeons National Cardiac Database. Ann Thorac Surg. 2007;31:267-275.

    Google Scholar 

  44. Rosenhek R, Rader F, Klaar U, et al. Outcome of watchful waiting in asymptomatic severe mitral regurgitation. Circulation. 2006;113:2238-2244.

    Article  PubMed  Google Scholar 

  45. Kang DH, Kim JH, Rim JH, et al. Comparison of early surgery versus conventional treatment in asymptomatic severe mitral regurgitation. Circulation. 2009;119:797-804.

    Article  PubMed  Google Scholar 

  46. Montant P, Chenot F, Robert A, et al. Long-term survival in asymptomatic patients with severe degenerative mitral regurgitation. A propensity score based comparison between an “early surgical” and a “conservative” treatment approach. J Thorac Cardiovasc Surg. 2009;138:1339-1348.

    Article  PubMed  Google Scholar 

  47. Ambler G, Omar RZ, Royston P, et al. Generic, simple risk stratification model for heart valve surgery. Circulation. 2005;112:224-231.

    Article  PubMed  Google Scholar 

  48. Suri RM, Schaff HV, Dearani JA, et al. Survival advantage and improved durability of mitral repair for leaflet prolapse subsets in the current era. Ann Thorac Surg. 2006;82:819-826.

    Article  PubMed  Google Scholar 

  49. Enriquez-Sarano M, Schaff HV, Orszulak TA, et al. Valve repair improves the outcome of surgery for mitral regurgitation. Circulation. 1995;91:1022-1028.

    CAS  PubMed  Google Scholar 

  50. Galloway AC, Colvin SB, Baumann FG, et al. Current concepts of mitral valve reconstruction for mitral insufficiency. Circulation. 1988;78:1087-1098.

    CAS  PubMed  Google Scholar 

  51. Lee EM, Shapiro LM, Wells FC. Superiority of mitral valve repair in surgery for degenerative mitral regurgitation. Eur Heart J. 1997;18:655-663.

    CAS  PubMed  Google Scholar 

  52. Yau TM, El-Ghoneimi YA, Armstrong S, et al. Mitral valve repair and replacement for rheumatic disease. J Thorac Cardiovasc Surg. 2000;119:53-60.

    Article  CAS  PubMed  Google Scholar 

  53. Mohty D, Orszulak TA, Schaff HV, et al. Very long-term survival and durability of mitral valve repair for mitral valve prolapse. Circulation. 2001;104:I1-I7.

    Article  CAS  PubMed  Google Scholar 

  54. Thourani VH, Weintraub WS, Guyton RA, et al. Outcomes and long-term survival for patients undergoing mitral valve repair versus replacement: effect of age and concomitant coronary artery bypass grafting. Circulation. 2003; 108:298-304.

    Article  PubMed  Google Scholar 

  55. Moss RR, Humphries KH, Gao M, et al. Outcome of mitral valve repair or replacement: a comparison by propensity score analysis. Circulation. 2003;108(Suppl 1):II90.

    PubMed  Google Scholar 

  56. Rozich JD, Carabello BA, Usher BW, et al. Mitral valve replacement with and without chordal preservation in patients with chronic mitral regurgitation. Circulation. 1992; 86:1718-1726.

    CAS  PubMed  Google Scholar 

  57. Hammermeister KE, Sethi GK, Henderson WG, et al. A comparison of outcomes in men 11 years after heart-valve replacement with a mechanical valve or bioprosthesis: Veterans Affairs Cooperative Study on Valvular Heart Disease. N Engl J Med. 1993;328:1289-1296.

    Article  CAS  PubMed  Google Scholar 

  58. Hammermeister K, Sethi GK, Henderson WG, et al. Outcomes 15 years after valve replacement with a mechanical versus a bioprosthetic valve: final report of the Veterans Affairs randomized trial. J Am Coll Cardiol. 2000;36: 1152-1158.

    Article  CAS  PubMed  Google Scholar 

  59. Grunkemeier GL, Starr A, Rahimtoola SH. Prosthetic heart valve performance: long-term follow-up. Curr Probl Cardiol. 1992;17:329-406.

    CAS  PubMed  Google Scholar 

  60. Block PC. Percutaneous mitral valve repair: are they changing the guard? Circulation. 2005;111:2154-2156.

    Article  PubMed  Google Scholar 

  61. Daimon M, Shiota T, Gillinov AM, et al. Percutaneous mitral valve repair for chronic ischemic mitral regurgitation: a real-time three-dimensional echocardiographic study in an ovine model. Circulation. 2005;111:2183-2189.

    Article  PubMed  Google Scholar 

  62. Feldman T, Wasserman HS, Herrmann HC, et al. Percutaneous mitral valve repair using the edge-to-edge technique six-month results of the EVEREST phase I clinical trial. J Am Coll Cardiol. 2005;46:2134-2140.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pôle de Recherche Cardiovasculaire, Institut de Recherche Expérimentale et Clinique, Université catholique de Louvain, Brussels, Belgium

    Jean-Louis Vanoverschelde

Authors
  1. Patrick Montant
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Agnès Pasquet
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Gébrine El Khoury
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jean-Louis Vanoverschelde
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-Louis Vanoverschelde .

Editor information

Editors and Affiliations

  1. Dept. Cardiothoracic Surgeon, Queen Elizabeth Hospital, Birmingham, B15 2TH, United Kingdom

    Robert S. Bonser

  2. Cardiothoracic Surgery, Beaumont Road 208, Birmingham, B30 1NX, United Kingdom

    Domenico Pagano

  3. Klinik für Herz-, Thorax-,, Transplantations- und Gefäßchirurgie, Medizinische Hochschule Hannover (MHH), Carl-Neuberg-Str. 1, Hannover, 30625, Germany

    Axel Haverich

Rights and permissions

Reprints and permissions

Copyright information

© 2010 Springer-Verlag London Limited

About this chapter

Cite this chapter

Montant, P., Pasquet, A., El Khoury, G., Vanoverschelde, JL. (2010). Chronic Mitral Regurgitation. In: Bonser, R., Pagano, D., Haverich, A. (eds) Mitral Valve Surgery. Springer, London. https://doi.org/10.1007/978-1-84996-426-5_3

Download citation

  • DOI: https://doi.org/10.1007/978-1-84996-426-5_3

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84996-425-8

  • Online ISBN: 978-1-84996-426-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation