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.
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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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
Davis PK, Kinmonth JB. The movements of the annulus of the mitral valve. J Cardiovasc Surg. 1963;4:427–31.Google Scholar
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.CrossRefPubMedGoogle Scholar
Toumanidis ST, Sideris DA, Papamichael CM, et al. The role of mitral annulus motion in left ventricular function. Acta Cardiol. 1992;47:331.PubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.PubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar
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.CrossRefPubMedGoogle Scholar