Three-dimensional echocardiography demonstrating the thickened mitral valve leaflets
with fused commissures (fish-mouth appearance) in parasternal short axis view, suggesting rheumatic mitral stenosis.
This finding associated with increased concentrations of 5HT in the mitral valve and myocardium with MMVD (13, 12), may indicate 5HT signalling in clinic been identified to have high serum levels of platelet-5HT, also mitral valve leaflets
and left ventricular myocardium in dogs with MMVD (13).
Dilated cardiomyopathy (DCM) is usually associated with variable degrees of FMR, due to mitral annular dilatation, which results in malcoaptation of the mitral valve leaflets
, or due to fibrosis of the sub-leaflet components of the mitral valve apparatus related to the etiology of left ventricular (LV) dysfunction.
DMV disease is the most common reason mitral valve leaflets
become floppy (prolapsed), causing the valve to leak.
Of these, it is estimated that 1-5% originate from the mitral valve leaflets
The mitral valve leaflets
were thickened with flail anterior segments (A1 andA2), hence neochordae were constructed for these segments in addition to ring annuloplasty using Sorin Memo 3D annuloplasty ring No.
Mitral regurgitation was diagnosed by the presence of thickened valves, dilated mitral valve annuli, and left atrial and left ventricular dilatation, and lack of coaptation of the mitral valve leaflets
Several long-term prognostic studies suggest that complications occur most commonly in patients with a mitral systolic murmur, those with thickened redundant mitral valve leaflets
, and those with increased left ventricular or left atrial size, especially in men older than 45 years.
The transcatheter, supra-annular approach does not interfere with the mitral valve leaflets
or chordae, and does not preclude subsequent treatment options if they become necessary.
"Mitral regurgitation [MR] is a condition in which the heart's mitral valve leaflets
do not close tightly.
Percutaneous mitral commissurotomy (PTMC) has been approved as a standard treatment in patients with severe rheumatic mitral stenosis with suitable valve score.1,2 The procedure is technically successful in over 90% patients, and the long-term durability of commissurotomy is excellent in those with pliable mitral valve leaflets
and minimally deformed submitral apparatus.The results are comparable to surgical commissurotomy in relieving the obstructed valve and maintaining a favourable outcome.2-7 Majority of cases undergo the procedure successfully using traditional transfemoral approach.