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Aortic-Mitral Coupling

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Advances in Treatments for Aortic Valve and Root Diseases

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Abstract

The aortic and mitral valve share a common fibrous border call the aortic-mitral curtain. Due to this anatomic linkage, normal aortic and mitral valve function are interdependent demonstrating coupled reciprocal behavior. Thus, during the cardiac cycle when aortic annular area is at its maximum, mitral annular area is at its minimum and vice versa. Additionally, the angle between the aortic and mitral valves is smallest during left ventricular ejection. Overall, this annular area reciprocity and angulation likely play a role in the efficiency of the heart as a pump.

When isolated aortic valve stenosis is present, changes to the ‘unaffected’ mitral valve occurs resulting in small mitral annular areas and reduced mitral annular function. These changes persist even with surgical or percutaneous treatment of the aortic valve. In contrast, in patients with degenerative mitral valve disease, the aortic valve appears to remain unaffected. However, after mitral valve repair with an annuloplasty ring, aortic annular pulsatility is reduced, which could impact normal aortic root function. Overall, diseases affecting the aortic or mitral valves and interventions to treat these diseases should include assessment of the impact on both valves.

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Authors and Affiliations

  1. Division of Cardiology, Department of Medicine, University of Toronto, Toronto General Hospital, University Health Network, Toronto, ON, Canada

    Wendy Tsang M.D., M.Sc.

  2. Section of Cardiology, Department of Medicine, Heart and Vascular Center, University of Chicago Medicine, Chicago, IL, USA

    Karima Addetia M.D. & Roberto M. Lang M.D.

Authors
  1. Wendy Tsang M.D., M.Sc.
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  2. Karima Addetia M.D.
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  3. Roberto M. Lang M.D.
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Corresponding author

Correspondence to Karima Addetia M.D. .

Editor information

Editors and Affiliations

  1. Department of Cardiothoracic and Vascular Surgery, GVM Care and Research, MEH, University of Palermo, Palermo, Italy

    Khalil Fattouch

  2. Department of Cardiology, University of Liège, Liège, Belgium

    Patrizio Lancellotti

  3. Marcus Heart Valve Center, Piedmont Heart Institute, Atlanta, GA, USA

    Mani A. Vannan

  4. Cardiovascular Surgery Department, GVM Care & Research, Anthea Hospital, Bari, Italy

    Giuseppe Speziale

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Tsang, W., Addetia, K., Lang, R.M. (2018). Aortic-Mitral Coupling. In: Fattouch, K., Lancellotti, P., Vannan, M., Speziale, G. (eds) Advances in Treatments for Aortic Valve and Root Diseases. Springer, Cham. https://doi.org/10.1007/978-3-319-66483-5_8

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  • DOI: https://doi.org/10.1007/978-3-319-66483-5_8

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-66482-8

  • Online ISBN: 978-3-319-66483-5

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