Mitral stenosis is due to chronic rheumatic carditis in all but a few cases. The gross pathological changes include; nodular and diffuse thickening of the mitral leaflets particularly along the coapting margins; fusion of the commissures to varying degrees resulting in a diminished mitral valve area; thickening and shortening and sometimes fusion of the chordae tendineae; secondary changes of the cardiac chambers due to the hemodynamic effects of left ventricular inflow obstruction. The fusion of the mitral commissures effectively moves the mitral orifice from the level of the mitral ring to the level of the coapting margins of the mitral leaflets. However, the left ventricular inflow obstruction is not always restricted to the orifice at the tip of the leaflets. Occasionally thickening and fusion of the chordae tendineae present further impedance to flow at the subvalvular level [1, 2].


Mitral Valve Mitral Regurgitation Leave Atrial Mitral Stenosis Mitral Valve Disease 
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© Martinus Nijhoff Publishing, Boston/Dordrecht/Lancaster  1985

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  • Peter M. Nichol

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