Left ventricular remodeling and functional mitral regurgitation: mechanisms and therapy.
Myocardial damage that results in dysfunction and remodeling changes left ventricular shape and size. Mitral competence requires the functional integrity of all components of the mitral apparatus. Progressive remodeling ultimately leads to geometric distortion of multiple elements of the mitral apparatus, resulting in functional mitral regurgitation (MR). In this article, we examine the mechanisms of functional MR in the remodeled ventricle. Surgical treatment should aim to correct all abnormalities of the mitral apparatus. These include (1) revascularization of viable myocardium, (2) reduction of ventricular volume and restoration of shape, (3) realignment of papillary muscles, and (4) reduction of annular orifice size.
Stanley
A W
AW
Department of Cardiology, Norwood Clinic and Kemp-Carraway Heart Institute, Birmingham, AL, USA.
Athanasuleas
C L
CL
Buckberg
G D
GD
D006801:Humans; D008944:Mitral Valve Insufficiency / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy; D011379:Prognosis; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology / Q000628:therapy; D020257:Ventricular Remodeling / Q000502:physiology*