Mitral valve surgery in the presence of leaflet restriction
The primary effects of active rheumatic carditis are annular dilatation and an inflammatory valvulitis. Dilatation of atrioventricular and semilunar valve annuli is common. Dilatation of the mitral annulus may be extremely marked and measure as much as twice the normal area. Thus, significant mitral annulus dilatation does not occur with the ventricular dilatation associated with congestive cardiomyopathy, ischemic heart disease and longstanding aortic regurgitation. The rheumatic process damages collagen fibres and the ground substance of connective tissue in the heart. Concentration of acute inflammatory cells to the region of insertion of the posterior leaflet of the mitral valve into the basal left ventricular myocardium has also been known. The failing diffusely diseased myocardium affected by acute rheumatic carditis has a tendency to dilate.
KeywordsMitral Valve Rheumatic Fever Mitral Stenosis Mitral Valve Prolapse Mitral Valve Surgery
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