Anatomy of the Mitral Valve Apparatus

Dal‐Bianco, Jacob P.; Levine, Robert A.

doi:10.1016/j.ccl.2013.03.001

Cited by 108 publications

(46 citation statements)

References 118 publications

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“…3D-TEE has been used extensively for MA assessment 13,[16][17][18][19][20][21][22] ; however, its utility in assessing the proposed D-shaped MA, Figure 4. A, Medial and lateral trigones are identified using both short-and long axis planes.…”

Section: Discussionmentioning

confidence: 99%

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Mak

Blanke

Ong

et al. 2016

Circ: Cardiovascular Imaging

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Background-Previously, through the use of computed tomography (CT), it has been proposed that D-shaped versus saddleshaped mitral annulus (MA) segmentation is more biomechanically appropriate to determine transcatheter mitral valve implantation size and eligibility. Methods and Results-Forty-one patients with severe mitral regurgitation being considered for transcatheter mitral valve implantation who had undergone cardiac CT and 3-dimensional transesophageal echocardiography (3D-TEE) were retrospectively evaluated. A standardized segmentation protocol for the D-shaped MA was developed using Philips Q-Laboratory mitral valve quantification software. MA dimensions were compared using Spearman's rank correlation and Bland-Altman analysis. Inter-and intraobserver agreement was quantified by intraclass correlation coefficient and Bland-Altman analysis. Mean age was 77±14 years; 71% male (n=29); mitral regurgitation pathogenesis was functional in 54% (n=22) and myxomatous in 46% (n=19

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Section: Discussionmentioning

confidence: 99%

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Mak

Blanke

Ong

et al. 2016

Circ: Cardiovascular Imaging

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“…17 Diagnostic specificity is required to study the genetic mutations associated with this MVP. Older studies lacked this specificity and suggested that MVP prevalence was as high as 10–15% or more, 85 often on the basis of 2D views that seemed to show prolapse because of the normal saddle shape of the valve, without actual pathological leaflet displacement.…”

Section: Mitral Valve Prolapsementioning

confidence: 99%

“…64,184 Furthermore, isolated anterior and inward displacement of the papillary muscles combined with leaflet elongation, especially of the posterior leaflet, can lead to SAM, the degree of which is related to leaflet length, even in the absence of septal hypertrophy. 15,17,185–192 …”

Section: Mitral Valve In Hcmmentioning

confidence: 99%

“…10,17,221,222 The use of 3D echocardiography in experimental studies has proved that global left ventricular dysfunction alone is insufficient to cause IMR. 223–225 Displacement and abnormal contraction of the left ventricular wall underlying the papillary muscles, along with decreased shortening of the distance between the papillary muscles, causes mitral leaflet tethering and restricted closure that leads to IMR (Figures 12a,b), 223–226 which is referred to as a Carpentier type IIIb lesion.…”

Section: Ischaemic Mitral Regurgitationmentioning

confidence: 99%

“…Imaging, most commonly cardiac ultrasonography, has a major role in the understanding of these structural mechanisms, 17 and reveals mitral valve biology by allowing correlations of valve structure, biomechanics, and haemodynamics with basic cellular, molecular, and genetic findings and, consequently, the development of new physiological therapies. In this Review, we provide an understanding of the mitral valve as a functional and interactive organ, beginning with consideration of how normal valve structure and biomechanical function are ideally matched as a result of choreographed development.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Mitral valve disease—morphology and mechanisms

Levine¹,

Hagège²,

Judge³

et al. 2015

Nat Rev Cardiol

Self Cite

319

254

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Mitral valve disease is a frequent cause of heart failure and death. Emerging evidence indicates that the mitral valve is not a passive structure, but—even in adult life—remains dynamic and accessible for treatment. This concept motivates efforts to reduce the clinical progression of mitral valve disease through early detection and modification of underlying mechanisms. Discoveries of genetic mutations causing mitral valve elongation and prolapse have revealed that growth factor signalling and cell migration pathways are regulated by structural molecules in ways that can be modified to limit progression from developmental defects to valve degeneration with clinical complications. Mitral valve enlargement can determine left ventricular outflow tract obstruction in hypertrophic cardiomyopathy, and might be stimulated by potentially modifiable biological valvular–ventricular interactions. Mitral valve plasticity also allows adaptive growth in response to ventricular remodelling. However, adverse cellular and mechanobiological processes create relative leaflet deficiency in the ischaemic setting, leading to mitral regurgitation with increased heart failure and mortality. Our approach, which bridges clinicians and basic scientists, enables the correlation of observed disease with cellular and molecular mechanisms, leading to the discovery of new opportunities for improving the natural history of mitral valve disease.

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Transcatheter Heart Valves: A Biomaterials Perspective

Bui

Khair

Yeats

et al. 2021

Adv Healthcare Materials

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Heart valve disease is prevalent throughout the world, and the number of heart valve replacements is expected to increase rapidly in the coming years. Transcatheter heart valve replacement (THVR) provides a safe and minimally invasive means for heart valve replacement in high‐risk patients. The latest clinical data demonstrates that THVR is a practical solution for low‐risk patients. Despite these promising results, there is no long‐term (>20 years) durability data on transcatheter heart valves (THVs), raising concerns about material degeneration and long‐term performance. This review presents a detailed account of the materials development for THVRs. It provides a brief overview of THVR, the native valve properties, the criteria for an ideal THV, and how these devices are tested. A comprehensive review of materials and their applications in THVR, including how these materials are fabricated, prepared, and assembled into THVs is presented, followed by a discussion of current and future THVR biomaterial trends. The field of THVR is proliferating, and this review serves as a guide for understanding the development of THVs from a materials science and engineering perspective.

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Anatomy of the Mitral Valve Apparatus

Cited by 108 publications

References 118 publications

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Three-Dimensional Echocardiography Compared With Computed Tomography to Determine Mitral Annulus Size Before Transcatheter Mitral Valve Implantation

Mitral valve disease—morphology and mechanisms

Transcatheter Heart Valves: A Biomaterials Perspective

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