Abstract
The mitral valve is part of the left ventricular outflow tract and of the aortic root; it facilitates the accommodation of blood, eventually followed by its rapid, efficient, and forceful ejection through the left ventricular outflow tract into the aortic root.
The mitral valve apparatus and the left ventricle are so interdependent that there is no mitral valve defect that does not affect the left ventricle in some way, and, in turn, there is no morphological or functional alteration of the left ventricle that has no consequence, to a greater or lesser extent, for the mitral valve. Therefore, the mitral valve is not a passive structure that moves solely as a result of the forces generated by cardiac activity, but rather a structure with its own sphincteric activity concentrated mainly in the annulus, which contributes to the ventricle’s contractility and, in turn, is heavily affected by it.
The mitral valve apparatus comprises the annulus and portion of myocardium located above and below it, the leaflets, the chordae tendineae, and the papillary muscles.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Di Mauro M, Gallina S, D’Amico MA, et al. Functional mitral regurgitation: from normal to pathological anatomy of mitral valve. Int J Cardiol. 2013;163:242–8.
Muresian H. The clinical anatomy of the mitral valve. Clin Anat. 2009;22:85–98.
Pollick C, Pittman M, Filly K, Fitzgerald PJ, Popp RL. Mitral and aortic valve orifice area in normal subjects and in patients with congestive cardiomyopathy: determination by two dimensional echocardiography. Am J Cardiol. 1982;49:1191–6.
van Rijk-Zwikker GL, Delemarre BJ, Huysmans HA. Mitral valve anatomy and morphology: relevance to mitral valve replacement and reconstruction. J Card Surg. 1994;9(2 Suppl):255–61.
Silverman ME, Hurst JW. The mitral complex: interaction of the anatomy, physiology, and pathology of the mitral annulus, mitral valve leaflets, chordae tendineae, and papillary muscles. Am Heart J. 1968;76:399.
Tsakiris AG, Von Bernuth G, Rastelli GC, et al. Size and motion of the mitral valve annulus in anesthetized intact dogs. J Appl Physiol. 1971;30:611.
Ormiston JA, Shah PM, Tei C, et al. Size and motion of the mitral valve annulus in man. I. A two-dimensional echocardiographic method and findings in normal subjects. Circulation. 1981;64:113.
Tsakiris AG, Sturm RE, Wood EH. Experimental studies on the mechanisms of closure of cardiac valves with use of roentgen videodensitometry. Am J Cardiol. 1973;32:136–43.
Davis PK, Kinmonth JB. The movements of the annulus of the mitral valve. J Cardiovasc Surg. 1963;4:427–31.
Keren G, Sonnenblick EH, LeJemtel TH. Mitral annulus motion. Relation to pulmonary venous and transmitral flows in normal subjects and in patients with dilated cardiomyopathy. Circulation. 1988;78:621–9.
Toumanidis ST, Sideris DA, Papamichael CM, et al. The role of mitral annulus motion in left ventricular function. Acta Cardiol. 1992;47:331.
Choure AJ, Garcia MJ, Hesse B, et al. In vivo analysis of the anatomical relationship of coronary sinus to mitral annulus and left circumflex coronary artery using cardiac multidetector computed tomography: implications for percutaneous coronary sinus mitral annuloplasty. J Am Coll Cardiol. 2006;48:1938–45.
Cook AC, Anderson RH. Attitudinally correct nomenclature. Heart. 2002;87:503–6.
van Gils FA. The fibrous skeleton in the human heart: embryological and pathogenetic considerations. Virchows Arch A Pathol Anat Histol. 1981;393:61.
Davila JC, Palmer TE. The mitral valve: anatomy and pathology for the surgeon. Arch Surg. 1962;84:174.
Perloff JK, Roberts WC. The mitral apparatus: functional anatomy of mitral regurgitation. Circulation. 1972;46:227.
Fenoglio J Jr, Tuan DP, Wit AL, et al. Canine mitral complex: ultrastructure and electromechanical properties. Circ Res. 1972;31:417.
Walmsley R. Anatomy of human mitral valve in adult cadaver and comparative anatomy of the valve. Br Heart J. 1978;40:35.
Anderson RH, Wilcox BR. The anatomy of the mitral valve. In: Wells FC, Shapiro LM, editors. Mitral valve disease. Oxford: Butterworth-Heinemann; 1996.
Fenster MS, Feldman MD. Mitral regurgitation: an overview. Curr Probl Cardiol. 1995;20:193.
Timek TA, Green GR, Tibayan FA, et al. Aorto-mitral annular dynamics. Ann Thorac Surg. 2003;76:1944–50.
Karlsson MO, Glasson JR, Bolger AF, Daughters GT, Komeda M, Foppiano LE, Miller DC, Ingels NB Jr. Mitral valve opening in the ovine heart. Am J Physiol. 1998;274:H552–63.
Levine RA, Triulzi MO, Harrigan P, Weyman AE. The relationship of mitral annular shape to the diagnosis of mitral valve prolapse. Circulation. 1987;75:756.
Sovak M, Lynch PR, Stewart GH. Movement of the mitral valve and its correlation with the first heart sound: selective valvular visualization and high-speed cineradiography in intact dogs. Invest Radiol. 1973;8:150–5.
Pohost GM, Dinsmore RE, Rubenstein JJ, et al. The echocardiogram of the anterior leaflet of the mitral valve: correlation with hemodynamic and cineroentgenographic studies in dogs. Circulation. 1975;51:88–97.
Tsakiris AG, Gordon DA, Mathieu Y, et al. Motion of both mitral valve leaflets: a cineroentgenographic study in intact dogs. J Appl Physiol. 1975;39:359–66.
Luther RR, Meyers SN. Acute mitral insufficiency secondary to ruptured chordae tendineae. Arch Intern Med. 1974;134:568.
Voci P, Bilotta F, Caretta Q, Mercanti C, Marino B. Papillary muscle perfusion pattern. A hypothesis for ischemic papillary muscle dysfunction. Circulation. 1995;91:1714–8.
Armour JA, Randall WC. Electrical and mechanical activity of papillary muscle. Am J Physiol. 1970;218:1710–7.
Cronin R, Armour JA, Randall WC. Function of the in-situ papillary muscle in the canine left ventricle. Circ Res. 1969;25:67–75.
Lam JH, Ranganathan N, Wigle ED, Silver MD. Morphology of the human mitral valve. I. Chordae tendineae: a new classification. Circulation. 1970;41:449–58.
Marzilli M, Sabbah HN, Lee T, Stein PD. Role of the papillary muscle in opening and closure of the mitral valve. Am J Physiol. 1980;238:H348–54.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2018 Springer International Publishing AG
About this chapter
Cite this chapter
Indorato, F., Cosentino, S.G., Bartoloni, G. (2018). Anatomy of the Mitral Apparatus. In: Tamburino, C., Barbanti, M., Capodanno, D. (eds) Percutaneous Treatment of Left Side Cardiac Valves. Springer, Cham. https://doi.org/10.1007/978-3-319-59620-4_1
Download citation
DOI: https://doi.org/10.1007/978-3-319-59620-4_1
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-59619-8
Online ISBN: 978-3-319-59620-4
eBook Packages: MedicineMedicine (R0)