Mitral valve repair for ischemic mitral incompetence
Ischemic mitral incompetence (IMI) is the most frequent mechanism of mitral regurgitation today and will continue to be so in the future, particularly in developed countries where rheumatic mitral valve disease has been nearly eradicated. It is a complex multifactorial entity related to coronary artery disease that is a frequent complication of myocardial infarction and associated with a poor prognosis. It involves global and regional left ventricular remodeling as well as dysfunction and distortion of the mitral valve (MV), including the chordae, annulus, and leaflets. Mitral regurgitation in the IMI mechanism is characterized by restrictive mitral leaflet mobility due to dyskinesia or even akinesia of the ventricular wall which bears one or both papillary muscles, thus, extending the distance between the ventricular wall and the leaflets, either both or, most frequently, predominantly the posterior leaflet. The posterior papillary muscle and its supporting ventricular wall and the posterior–inferior wall of the left ventricle are most frequently affected.
KeywordsMitral Valve Mitral Regurgitation Papillary Muscle Mitral Valve Replacement Mitral Valve Repair
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