Abstract
Echocardiography is an essential tool in managing patients with mitral regurgitation. It allows identification and precise summation of anatomic lesions that lead to valve dysfunction. In this article, we highlight important aspects of mitral valve anatomy and pathophysiology as they pertain to surgical repair and discuss the critical role of echocardiography in surgical planning and assessment. Better understanding of surgical anatomy of the mitral valve and systematic segmental valve analysis by echocardiographers will allow easy identification of complex valve lesions or dysfunctions that require advanced surgical skill, techniques, or expertise to affect a repair. By triggering referral of such patients to “reference” mitral valve surgeons and by providing information that enables the surgeons to adequately plan a repair preoperatively, echocardiographers will help eliminate the scenario in which mitral valve replacements are performed because the surgeons discover intraoperatively that it is beyond their skill to repair a valve.
Similar content being viewed by others
References and Recommended Reading
Carpentier A: Cardiac valve surgery—the “French correction”. J Thorac Cardiovasc Surg 1983, 86:323–337.
Rodriguez F, Langer F, Harrington KB, et al.: Importance of mitral valve second-order chordae for left ventricular geometry, wall thickening mechanics, and global systolic function. Circulation 2004, 110:II115–II122.
Rodriguez F, Langer F, Harrington KB, et al.: Effect of cutting second-order chordae on in-vivo anterior mitral leaflet compound curvature. J Heart Valve Dis 2005, 14:592–601.
Dreyfus GD, Bahrami T, Alayle N, et al.: Repair of anterior leaflet prolapse by papillary muscle repositioning: a new surgical option. Ann Thorac Surg 2001, 71:1464–1470.
Carpentier A, Chauvaud S, Fabiani JN, et al.: Reconstructive surgery of mitral valve incompetence: ten-year appraisal. J Thorac Cardiovasc Surg 1980, 79:338–348.
Carpentier AF, Lessana A, Relland JY, et al.: The “physioring”: an advanced concept in mitral valve annuloplasty. Ann Thorac Surg 1995, 60:1177–1185.
Anyanwu AC, Adams DH: Etiologic classification of degenerative mitral valve disease: Barlow’s disease and fibroelastic deficiency. Semin Thorac Cardiovasc Surg 2007, 19:90–96.
Zoghbi WA, Enriquez-Sarano M, Foster E, et al.: Recommendations for evaluation of the severity of native valvular regurgitation with two-dimensional and Doppler echocardiography. J Am Soc Echocardiogr 2003, 16:777–802.
Enriquez-Sarano M, Avierinos JF, Messika-Zeitoun D, et al.: Quantitative determinants of the outcome of asymptomatic mitral regurgitation. N Engl J Med 2005, 352:875–883.
Pu M, Thomas JD, Vandervoort PM, et al.: Comparison of quantitative and semiquantitative methods for assessing mitral regurgitation by transesophageal echocardiography. Am J Cardiol 2001, 87:66–70.
Adams DH, Anyanwu A: Pitfalls and limitations in measuring and interpreting the outcomes of mitral valve repair. J Thorac Cardiovasc Surg 2006, 131:523–529.
Maslow AD, Regan MM, Haering JM, et al.: Echocardiographic predictors of left ventricular outflow tract obstruction and systolic anterior motion of the mitral valve after mitral valve reconstruction for myxomatous valve disease. J Am Coll Cardiol 1999, 34:2096–2104.
Gillinov AM, Cosgrove DM III: Modified sliding leaflet technique for repair of the mitral valve. Ann Thorac Surg 1999, 68:2356–2357.
Maslow AD, Singh A: Mitral valve repair: to slide or not to slide-precardiopulmonary bypass echocardiogram examination. J Cardiothorac Vasc Anesth 2006, 20:842–846.
Bridgewater B, Hooper T, Munsch C, et al.: Mitral repair best practice: proposed standards. Heart 2006, 92:939–944.
Adams DH, Anyanwu AC: The cardiologist’s role in increasing the rate of mitral valve repair in degenerative disease. Curr Opin Cardiol 2008, 23:105–110.
Bonow RO, Carabello BA, Kanu C, et al.: ACC/AHA 2006 guidelines for the management of patients with valvular heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (writing committee to revise the 1998 Guidelines for the Management of Patients With Valvular Heart Disease): developed in collaboration with the Society of Cardiovascular Anesthesiologists: endorsed by the Society for Cardiovascular Angiography and Interventions and the Society of Thoracic Surgeons. Circulation 2006, 114:e84–e231.
Flameng W, Meuris B, Herijgers P, Herregods MC: Durability of mitral valve repair in Barlow disease versus fibroelastic deficiency. J Thorac Cardiovasc Surg 2008, 135:274–282.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Adams, D.H., Anyanwu, A.C., Sugeng, L. et al. Degenerative mitral valve regurgitation: Surgical echocardiography. Curr Cardiol Rep 10, 226–232 (2008). https://doi.org/10.1007/s11886-008-0038-9
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11886-008-0038-9