The left ventricle and its systolic function
Andrew R. Houghton in MAKING SENSE of Echocardiography, 2013
Mitral stenosis is the obstruction of diastolic blood flow from the left atrium to the left ventricle (LV) due to a narrowing of the mitral valve. Mitral valve area can also be calculated using the continuity equation. This calculation relies on volume of blood entering the LV via the mitral valve orifice during diastole being equal to the volume of blood leaving the LV via the LV outflow tract during systole. The mitral valve is rheumatic in appearance, with fusion of leaflets at both commissures and moderate thickening of both leaflet tips and the chordae tendineae. Mitral regurgitation is the flow of blood from the LV back through the mitral valve during systole. Three-dimensional echo is proving to be extremely useful in assessing mitral valve disease and in planning surgery. Drug therapy is mainstay of treatment in functional mitral regurgitation secondary to cardiomyopathy, although mitral valve surgery may be considered in those with severe functional regurgitation and severely impaired LV function.
V ALVULAR
Joseph G. Murphy, Margaret A. Lloyd in Mayo Clinic Cardiology Concise Textbook and Mayo Clinic Cardiology Board Review Questions & Answers, 2008
MITRAL REGURGITATION The mitral valve is a complicated structure that requires the correct functioning of the valve leaflets, valve commissures, mitral anulus, papillary muscles, chordae tendineae, and left ventricle for competence. Mitral regurgitation results from failure of one or more of the components of normal mitral valve competence. The presentation and management depend on the underlying cause, duration, regurgitant severity, patient symptoms (including objective exercise tolerance), and left ventricular size and systolic function.
Normal Anatomy, Normal TEE, Normal Doppler
Martin G. St. John Sutton, Alan R. Maniet in Mitral Valve Transesophageal Echocardiography, 2005
The mitral valve sits in the fibrous skeleton of the heart separating the left atrium from the left ventricle (Figure 2.1). The normal mitral valve has two leaflets that act in conjunction with the subvalvular apparatus as one functional unit.1-6 The mitral leaflets are attached at their bases to the fibro-muscular ring or annulus fibrosis, and by their free edges to the subvalvular apparatus consisting of chordae tendineae and papillary muscles.
Parachute mitral valve in a young adult with recurrent pulmonary oedema
Published in Acta Cardiologica, 2011
Justyna Rybicka, Piotr Dobrowolski, Mariusz Kuśmierczyk, Jacek Rózski, Mirosław Kowalski, Piotr Hoffman
A parachute mitral valve is a rare congenital malformation resulting from fusion of the mitral chordae tendineae and their attachment to the one prominent papillary muscle. It can be found either as an isolated lesion or, more often, associated with left heart obstructive lesions, patent ductus arteriosus or ventricular septal defect. Congenital mitral stenosis usually presents with severe symptoms in early childhood, otherwise remains stable and hardly ever requires surgical intervention. We present a case of a young adult with severe stenosis of a parachute mitral valve and history of recurrent pulmonary oedema treated by mitral commissurotomy.
The spectrum of mitral valve pathologies: relevance for surgical and structural interventions
Published in Expert Review of Cardiovascular Therapy, 2017
Sho Torii, Maria E. Romero, Hiroyoshi Mori, Emanuel Harari, Frank D. Kolodgie, Aloke V. Finn, Renu Virmani
Introduction: The mitral valve apparatus, both functionally and morphologically is composed of a constellation of individual structures, including the annulus, anterior and posterior leaflets, chordae tendineae, and papillary muscles. Most also include the left ventricular wall and the left atrium which are essential for the valve to function normally. Areas covered: The commonest conditions responsible for mitral valve dysfunction in the Western World are degenerative and functional mitral regurgitation, which are discussed in detail. Treatment strategies in patients at high surgical risk are rapidly evolving, as more options for transcatheter mitral valve repair and replacement become available. Expert commentary: Although surgery remains the gold standard, many elderly patients with severe comorbidities need intervention as surgery may no longer be an option. Today, transcatheter mitral valve therapies are in their infancy but with advances in technology they will likely become tomorrow’s therapy. The heart team plays an important role, discussing and addressing individualized strategies for each patient. However, a thorough knowledge and the understanding of mitral valve anatomy, pathology, and clinical assessment is mandatory in order to choose the best treatment possible.
Innervation of the atrioventricular and semi-lunar heart valves: a review
Published in Acta Cardiologica, 2006
Christophe Borin, Daniel Vanhercke, Andre Weyns
Heart valves were historically considered passive structures that function through the haemodynamic forces created by the contraction and relaxation of the myocardium. However, research into valvular structures has revealed that heart valves are very complex, specialized structures that contain both smooth muscle cells and nerve fibres. This is particularly true for the atrioventricular valves, which are by far the most well studied to date. The various heart valves have been shown to contract independently during different moments of the heart cycle, suggesting that compensatory adaptation mechanisms exist to mediate the timing and efficacy of heart valve closure.These adaptations occur via different mechanisms, including neural mechanisms that influence the heart valves. Accumulating evidence continues to improve our understanding of the nerve fibres in the heart (adrenergic, cholinergic, etc.). Future studies will no doubt add to this exciting picture. Here, we review the current morphological knowledge of human and animal heart valve innervation, including discussions of the chordae tendineae and the papillary muscles, as well as the differences between the atrioventricular (AV) valves and the semi-lunar (SL) valves.
Related Knowledge Centers
- Aorta
- Heart Atria
- Heart Valves
- Heart Ventricles
- Blood
- Pulmonary Arteries
- Papillary Muscles