Mechanism of valvular regurgitation.

Abstract:

PURPOSE OF REVIEW:Despite improvements in surgical techniques, valvular regurgitation results in major morbidity in children with heart disease. Functional anatomy, mechanisms of valve closure and adaptation to changing hemodynamic stress in normal mitral and tricuspid valves are complex and only partially understood. As well, pathology of atrioventricular valve regurgitation is further complicated by congenital valve abnormalities involving leaflet tissue, supporting chordal apparatus and displaced papillary muscles. This review provides a current understanding of the mechanisms that result in atrioventricular valve failure. RECENT FINDINGS:Mitral valve leaflets have contractile elements, in addition to atrial muscle modulation of leaflet tension. When placed under mechanical tethering stress, the mitral valve adapts by leaflet expansion, which increases coaptation surface reserve and chordal thickening. Both pediatric and adult studies are increasingly reporting on the importance of subvalvar apparatus function in maintaining valve competency. SUMMARY:The maintenance of efficient valve function is accomplished by a complex series of events involving atrial and annular contraction, annular deformation, active leaflet tension, chordal transmission of papillary muscle contractions and ventricular contraction.

journal_name

Curr Opin Pediatr

authors

Khoo NS,Smallhorn JF

doi

10.1097/MOP.0b013e32834aa56a

subject

Has Abstract

pub_date

2011-10-01 00:00:00

pages

512-7

issue

5

eissn

1040-8703

issn

1531-698X

pii

00008480-201110000-00004

journal_volume

23

pub_type

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