The echocardiographic investigation of the mitral valve shows which leaflet is degenerated , if the leaflet , and the ring , maintained the integrity , the state of the attachment for the chorda tendinae , the structure of the papillary muscles . Two follow - up studies present the outcome of the mitral valvuloplasty for the elderly patients .
A study presents the clinical findings for a man of 74 years old . He did not have regurgitation of the tricuspid valve before he had a prosthetic replacement for the mitral valve . The left side of the heart stabilised with the surgery . The aortic valve had an unaffected functioning mechanism . The postoperative atrial fibrillation progressed. The postoperative regurgitation of the tricuspid valve made an impact on the right side of the heart .
The rheumatic heart disease ( RHD ) , and the dilated cardiomyopathy ( DCM ) are the causes for the stenosis ( MS ) , and for the regurgitation ( MR ) of the mitral valve ( figure 1 ) . The effects of the increased pressure in the left atrium are the increased size of the left atrium , the atrial fibrillation , and the pulmonary hypertension . The atrial fibrillation produces the dilation for the ring of the tricuspid valve . The pulmonary hypertension generates the dilation of the right ventricle ( RV ) . The regurgitation of the tricuspid valve ( TV ) worsens the tethering of the tricuspid valve , and the dilation of the right ventricle .
Figure 1 . The regurgitation of the tricuspid valve after the mitral valvuloplasty . Copyright ( 2009 ) Journal of The American College of Cardiology .
Another follow - up study analyses the clinical outcome for 242 patients who had valvuloplasty for the repair of the mitral valve . The patients are free from the non - trivial regurgitation of the mitral valve in 94 . 3 ± 1 . 6 % after one month , 58 . 6 ± 4 . 9 % after five years , and 27 . 2 ± 8 . 6 % after seven years ( figure 2 ) . The freedom from the severe regurgitation of the mitral valve is 98 . 3 ± 0 . 9 % after one month , 82 . 8 ± 3 . 8 % after five years , and 71 . 1 ± 7 . 4 % after seven years .
Figure 2 . The non - trivial regurgitation of the mitral valve . Copyright ( 2003 ) Circulation .
The dysfunction of the mitral valve is generated by the rheumatic heart disease , by the ischemic heart disease , and by the bacterial endocarditis . The succes of the replacement for the mitral valve is assessed both in the short term , and in the long term effects on the quality of life for the patient .
References :
Flameng W . , Herijgers P . , Bogaers K . ( 2003 ) “ The clinical anatomy and pathology of the human arterial valves : implications for repair or replacement ” , Circulation , 107 , 1609 - 1613 .
Shiran A . , Sagie A . ( 2009 ) “ Tricuspid regurgitation in mitral valve disease : incidence , prognostic implications , mechanism , and management ” , Journal of The American College of Cardiology , 53 ( 5 ) , 401 - 408 .
