Abstract
The function of the mitral valve is dependent on the precise interaction of cusps, chordae, ventricular base, and the posterior ventricular wall. For closure to take place with or without atrial contraction, a vortex forms behind the anterior cusp and moves it posteriorly, and the ventricular muscle starts to develop tension. With this the ventricular pressure rises, reversing the diastolic forward flow of blood through the orifice. Closure occurs after systole has started, just before the aortic valve opens. The normal annulus narrows, bringing the posterior cusp nearer to the anterior cusp and the posterior left ventricular wall shortens allowing the cusps to rise to the plane of the atrioventricular ring. A small puff of regurgitation occurs as the cusps close. Most of this is blood displaced by the cusps as their contact progresses from a touching of the free edges to contact over a substantial area [2, 3].
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Carpentier A (1988) Personal communication
Frater RWM (1961) Mitral valve anatomy and prosthetic valve design. Proc staff meet. Mayo Clin Proc 36:23
Frater RWM (1986) Functional anatomy of the mitral valve. In: Ionescu M, Cohn L (eds) But-terworths 8:123–134
Frater RWM, Gabbay S, Shore S, Factor S, Strom J (1983) Reproducible replacement of elongated or ruptured mitral valve chordae. Ann Thorac Surg 35(l):14–28
Godley RW, Wann LS, Rogers EW, Feigenbaum H, Weyman AE (1981) Incomplete mitral leaflet closure in patients with papillary muscle dysfunction. Circulation 63:565–571
Hagl S, Heimisch W, Meister H, Mendier N, Sebening F (1984) In situ function of the papillary muscle in the canine left ventricle. In: Duran C, Angen WA, Johnson AD, Oury JM (eds) Recent progress in mitral valve disease. Butterworths, London, p 397–409
Izumi S, Miyatake K, Beppu S, Park YD, Nagata S, Kinoshita N, Sakakibara H, Nimura Y (1987) Mechanism of mitral regurgitation in patients with myocardial infarction: a study using real-time two-dimensional Doppler flow imaging and echocardiography. Circulation 76:777–785
Kay JM, Zubiate P, Mendez MA, Vanstrom N, Yokoyama T, Gharari MA (1980) Surgical treatment of mitral insufficiency secondary to coronary artery disease. J Thorac Cardiovasc Surg 79:12
McAlpine WA (1975) Heart and coronary arteries. Springer, Berlin Heidelberg New York
Miller GE Jr, Cohn KE, Kerth WF, Selzer A, Gerbode F (1968) Experimental papillary muscle infarction. J Thorac Cardiovasc Surg 56:611–616
Tei C, Sakamake T, Shah PM, Meerbaum S, Kondo S, Shimoura K, Corday E (1983) Mitral valve prolapse in short-term experimental coronary occlusion: a possible mechanism of ischemic mitral regurgitation. Circulation 68:183–189
Yellin EL, Yoran C, Sonnenblick EH, Gabbay S, Frater RWM (1979) Dynamic changes in the canine mitral regurgitant orifice area during ventricular ejection. Circ Res 45:667–683
Yoran C, Yellin EL, Becker RM, Gabbay S, Frater RWM (1979) Mechanism for reduction of mitral regurgitation with vasodilator therapy. Am J Cardiol 43:773–777
Yoran C, Yellin EL, Becker RM, Gabbay S, Frater RWM (1979) Dynamic aspects of mitral regurgitation: effects of ventricular volume, pressure and contractility on the effective regurgitation orifice area. Circulation 60:170–176
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Frater, R.W.M., Cornelissen, P., Sisto, D. (1991). Mechanisms of ischemic mitral insufficiency and their surgical correction. In: Vetter, H.O., Hetzer, R., Schmutzler, H. (eds) Ischemic Mitral Incompetence. Steinkopff, Heidelberg. https://doi.org/10.1007/978-3-662-08027-6_10
Download citation
DOI: https://doi.org/10.1007/978-3-662-08027-6_10
Publisher Name: Steinkopff, Heidelberg
Print ISBN: 978-3-662-08029-0
Online ISBN: 978-3-662-08027-6
eBook Packages: Springer Book Archive