RT Book, Section
A1 Castillo, Javier G.
A1 Adams, David H.
A1 Carabello, Blase A.
A1 Sengupta, Partho P.
A2 Fuster, Valentin
A2 Harrington, Robert A.
A2 Narula, Jagat
A2 Eapen, Zubin J.
SR Print(0)
ID 1161731456
T1 DEGENERATIVE MITRAL VALVE DISEASE
T2 Hurst's The Heart, 14e
YR 2017
FD 2017
PB McGraw-Hill Education
PP New York, NY
SN 9780071843249
LK accessmedicine.mhmedical.com/content.aspx?aid=1161731456
RD 2024/04/19
AB The  normal  mitral  valve  permits  one-way  blood  flow  from  the  left  atrium  to  the  left  ventricle  in  an  efficient,  nearly  frictionless  fashion.1  Although  even  a  normal  competent  valve  may  allow  a  trivial  amount  of  reversed  flow,  more  than  a  trace  of  mitral  regurgitation  is  considered  pathologic.2  Mild-to-moderate  mitral  regurgitation  is  tolerated  indefinitely  as  long  as  it  does  not  worsen.  However,  severe  mitral  regurgitation  causes  left  ventricular  remodeling  reduced  forward  cardiac  output,  neurohumoral  activation,  left  ventricular  damage,  heart  failure,  and  ultimately  death.3  The  natural  history  of  mitral  regurgitation  depends  intimately  on  its  etiology,  the  severity  of  left  ventricular  volume  overload  as  well  as  its  contractile  performance,  and  the  appearance  of  overlapping  clinical  conditions  secondary  to  reversal  flow,  such  as  atrial  fibrillation  and  pulmonary  hypertension.4  In  this  setting,  myxomatous  degeneration  of  the  mitral  valve,  a  very  common  pathologic  substrate  of  mitral  valve  billowing  (normal  valve  coaptation)  and  prolapse  (deficient  valve  coaptation),  is  the  most  prevalent  cause  of  isolated  severe  mitral  regurgitation  requiring  surgical  intervention  in  the  United  States.5  The  following  is  a  review  of  the  normal  mitral  valve  anatomy  as  well  as  a  summary  of  causes,  consequences,  and  treatment  of  degenerative  mitral  valve  regurgitation.