Mitral valve replacement is a procedure whereby the diseased mitral valve of a patient's heart is replaced by either a mechanical or tissue (bioprosthetic) valve. The mitral valve may need to be replaced because: The valve is leaky (mitral valve regurgitation) The valve is narrowed and doesn't open properly (mitral valve stenosis) Causes of mitral valve disease include infection, calcification and inherited collagen disease. Current mitral valve replacement approaches include open heart surgery and minimally invasive cardiac surgery (MICS). The mitral valve is a bileaflet valve sited between the left atrium and left ventricle, responsible for preventing blood flowing from the ventricle to the atrium when the heart contracts. It is elliptical, and its area varies from 5.0 to 11.4 cm2. The valve leaflets are separated by two commissures, and each leaflet of the valve (anterior leaflet, the large one, and posterior leaflet, the small one) has three sections (p1, p2, p3). Histologically, each leaflet is composed of the solid fibrosa, the spongiosa at the atrial surface and another fibroelastic layer covering the leaflets. Two papillary muscles originating from the base of the left ventricle hold the mitral leaflets in place through chordae tendinae, which insert the edge of the leaflets, preventing them from leaking during left ventricle systole. During normal mitral valve function fluid jets from the left atrium through the mitral valve into the left ventricle. The vortex created from this jetting travels towards the apex of the left ventricle because of the asymmetric shape of the mitral valve leaflets. This vortex rotates clockwise until the isovolumetric contraction of the left ventricle opens the aortic valve and redirects the fluid flow from the apex of the left ventricle to the systemic circulation and the rest of the body. It is important to emphasize that the asymmetry of the mitral valve is very important in the diastolic flow patterns of transmitral flow.

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Related concepts (2)
Atrial fibrillation
Atrial fibrillation (AF or A-fib) is an abnormal heart rhythm (arrhythmia) characterized by rapid and irregular beating of the atrial chambers of the heart. It often begins as short periods of abnormal beating, which become longer or continuous over time. It may also start as other forms of arrhythmia such as atrial flutter that then transform into AF. Episodes can be asymptomatic. Symptomatic episodes may involve heart palpitations, fainting, lightheadedness, shortness of breath, or chest pain.
Mitral regurgitation
Mitral regurgitation (MR), also known as mitral insufficiency or mitral incompetence, is a form of valvular heart disease in which the mitral valve is insufficient and does not close properly when the heart pumps out blood. It is the abnormal leaking of blood backwards – regurgitation from the left ventricle, through the mitral valve, into the left atrium, when the left ventricle contracts. Mitral regurgitation is the most common form of valvular heart disease.

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