Diseases of the mitral valve

The mitral valve is a complex structure that consists of several components, each of which plays a fundamental role in its function. These include the mitral annulus, anterior and posterior leaflets, chordae tendineae, and papillary muscles. The function of the valve may also be affected by anomalies of the left atrium and ventricle, for example, mitral regurgitation caused by left atrial dilatation or papillary muscle dysfunction due to ischemia of the surrounding left ventricular myocardium.

Mitral valve prolapse, isolated cleft of the anterior mitral valve leaflet, double orifice mitral valve, and supravalvar mitral membrane are the most common abnormalities affecting the mitral valve leaflets. Mitral valve straddling and parachute mitral valve are examples of anomalies of the tensor apparatus. Rheumatic heart disease is the most common cause of acquired mitral valve disease and is an important source of morbidity and mortality in pediatric patients in developing countries.

From a functional point of view, mitral valve abnormalities can lead to varying degrees of regurgitation or stenosis. Due to the critical importance of the mitral valve, these disorders are typically clinically poorly tolerated. Cardiac surgery is the treatment of choice in patients with mitral valve disease, but despite recent advances in valve preserving surgical techniques, mitral valve replacement may often represent the only treatment option.