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Giornale Italiano Di Cardiologia 1981In this paper we have reviewed the salient features of the anatomy of mitral atresia which should be of interest to the clinician. In the preceding paper, we reviewed... (Review)
Review
In this paper we have reviewed the salient features of the anatomy of mitral atresia which should be of interest to the clinician. In the preceding paper, we reviewed the comparable features of tricuspid atresia, defined as lack of exit from the systemic venous atrium, even though some of the lesions may have affected a morphologically mitral valve. In this paper, we consider lesions producing lack of exit from the pulmonary venous atrium even though some of them may affect a morphologically tricuspid valve. Left atrioventricular valve atresia is a more accurate term, but mitral atresia is used because of its clinical applications. As with tricuspid atresia, mitral atresia may be due to either absence of an atrioventricular connexion or to presence of an imperforate valve membrane. In the setting of mitral atresia, the distinction is rarely if ever of practical clinical significance but understanding of the difference is essential for correct interpretation of the anatomy. When the left connexion is absent, the atrioventricular sulcus tissue completely separates the muscular floor of the left atrium from the underlying ventricular myocardium. When an imperforate valve membrane is present, it separates the cavity of the left atrium from an underlying ventricular cavity. Either of these lesions can be found with all the various forms of mitral atresia. The major anatomical subdivision is into groups with co-existing aortic atresia and with a patent aortic root. With aortic atresia, almost invariably the right atrium is connected to a right ventricular chamber. When there is a patent aortic root, the right atrium can be connected to a right ventricular chamber, a left ventricular chamber or rarely an indeterminate ventricular chamber, and these forms can all be found with various ventriculo-arterial connexions. The anatomical features are illustrated with diagrams and with hearts sectioned so as to simulate diagnostic planes used during two-dimensional echocardiographic examination. The convention used for categorizing these hearts as either biventricular or univentricular is discussed, emphasizing how disagreements about such nosological matters should be subordinate to accurate description of the underlying anatomy.
Topics: Aortic Valve; Echocardiography; Genetic Variation; Humans; Mitral Valve; Myocardium
PubMed: 7049816
DOI: No ID Found -
American Heart Journal Aug 1958
Topics: Heart Valve Diseases; Humans; Mitral Valve
PubMed: 13545179
DOI: 10.1016/0002-8703(58)90243-6 -
Pediatric Cardiology Dec 2019We here report a neonate with prenatal echocardiographic diagnosis of tricuspid atresia, with normally related great vessels, and large ventricular septal defect. This...
We here report a neonate with prenatal echocardiographic diagnosis of tricuspid atresia, with normally related great vessels, and large ventricular septal defect. This diagnosis could be confirmed with echocardiography at birth. An additional double mitral orifice was also seen. This is a very rare association.
Topics: Echocardiography; Female; Humans; Infant, Newborn; Mitral Valve; Prenatal Diagnosis; Tricuspid Atresia
PubMed: 31506732
DOI: 10.1007/s00246-019-02204-1 -
The Journal of Thoracic and... Dec 1979
Topics: Animals; Blood Vessel Prosthesis; Dogs; Heart Defects, Congenital; Heart Valve Prosthesis; Mitral Valve
PubMed: 502577
DOI: No ID Found -
Swiss Medical Weekly Jan 2010Mitral regurgitation (MR) involves systolic retrograde flow from the left ventricle into the left atrium. While trivial MR is frequent in healthy subjects, moderate to... (Review)
Review
Mitral regurgitation (MR) involves systolic retrograde flow from the left ventricle into the left atrium. While trivial MR is frequent in healthy subjects, moderate to severe MR constitutes the second most prevalent valve disease after aortic valve stenosis. Major causes of severe MR in Western countries include degenerative valve disease (myxomatous disease, flail leaflet, annular calcification) and ischaemic heart disease, while rheumatic disease remains a major cause of MR in developing countries. Chronic MR typically progresses insidiously over many years. Once established, however, severe MR portends a poor prognosis. The severity of MR can be assessed by various techniques, Doppler echocardiography being the most widely used. Mitral valve surgery is the only treatment of proven efficacy. It alleviates clinical symptoms and prevents ventricular dilatation and heart failure (or, at least, it attenuates further progression of these abnormalities). Valve repair significantly improves clinical outcomes compared with valve replacement, reducing mortality by approximately 70%. Reverse LV remodelling after valve repair occurs in half of patients with functional MR. Percutaneous, catheter-based to mitral valve repair is a novel approach currently under clinical scrutiny, with encouraging preliminary results. This modality may provide a valuable alternative to mitral valve surgery, especially in critically ill patients.
Topics: Aged; Female; Humans; Male; Mitral Valve; Mitral Valve Insufficiency
PubMed: 19950042
DOI: 10.4414/smw.2010.12893 -
British Heart Journal Mar 1984The morphological characteristics of mitral atresia were studied in 30 hearts to determine the presence or absence of a morphological rudiment of the atretic valve and...
The morphological characteristics of mitral atresia were studied in 30 hearts to determine the presence or absence of a morphological rudiment of the atretic valve and the relation of this rudiment, if found, to any chamber in the ventricular mass. All the hearts showed atrial situs solitus and no ventricular inversion; consequently all had left atrioventricular atresia. In all instances dense fibrous tissue connected the floor of the left atrium to the left ventricle. This connective tissue is considered to be the morphological rudiment of the atretic mitral valve. In several hearts the intervening fibrous tissue varied from a thick fibrous membrane to a tiny fibrous cord; it is impossible to detect these variations clinically. It is, therefore, more practical to classify those hearts which have a detectable fibrous membrane macroscopically as having an "imperforate membrane" and those with a fibrous strand detectable only microscopically as having an "absent atrioventricular connection."
Topics: Heart Defects, Congenital; Heart Ventricles; Humans; Mitral Valve; Terminology as Topic
PubMed: 6696802
DOI: 10.1136/hrt.51.3.252 -
Journal of Cardiovascular Echography 2015Mitral atresia is a rare congenital heart defect when compared to atresia of other valves and it is often associated with other cardiac malformation such as patent...
Mitral atresia is a rare congenital heart defect when compared to atresia of other valves and it is often associated with other cardiac malformation such as patent ductus arteriosus, coarctation of the aorta, transposition of the great arteries, pulmonary stenosis, shunt defects, cor triatriatum, chamber, and valvular anomalies. There have been few reports of mitral atresia, therefore, the case of a 5-month-old male child with complaint of difficulty with breathing and echocardiographic diagnosis of atretic mitral valves, atrial septal defect of 15 mms, ventricular septal defect (VSD) of 10 mms and hypoplastic left ventricle is reported.
PubMed: 28465939
DOI: 10.4103/2211-4122.166078 -
The Annals of Thoracic Surgery Nov 2010Mitral stenosis with aortic atresia (MS-AA) has been implicated as a risk factor for decreased survival after stage 1 palliation for hypoplastic left heart syndrome....
BACKGROUND
Mitral stenosis with aortic atresia (MS-AA) has been implicated as a risk factor for decreased survival after stage 1 palliation for hypoplastic left heart syndrome. Conflicting results were reported in the literature evaluating the association of anatomic subtypes and mortality. Our objective was to determine whether MS-AA is associated with increased mortality after stage 1 palliation.
METHODS
Between January 2005 and May 2009 100 consecutive neonates with hypoplastic left heart syndrome underwent stage 1 palliation. Echocardiograms were reviewed for patency of the mitral and aortic valves as well as presence of ventriculocoronary connections (VCC). Patients were divided into (1) mitral and aortic atresia (MA-AA), (2) MS-AA, and (3) mitral and aortic stenosis groups. Survival analysis was performed, and impact of MS-AA and VCC on early and midterm survival was assessed.
RESULTS
Of the 100 patients, 31 had MA-AA, 42 had mitral stenosis and aortic stenosis, and 27 had MS-AA (15 with VCC and 12 without). Stage 1 palliation 30-day survival was 90% for the entire cohort and 88.9% for the MS-AA subtype (not significantly different). Six-month survival was 70% overall and 70.4% for MS-AA (not significantly different). When VCC was taken into account, MS-AA with VCC reached 93% survival (versus 50% for MS-AA without VCC; p < 0.01).
CONCLUSIONS
Stage 1 palliation for hypoplastic left heart syndrome is associated with satisfactory hospital and midterm survival regardless of anatomic subtype. The variants MS-AA and MA-AA are associated with smaller ascending aorta. Mitral stenosis with aortic atresia or VCC did not adversely influence survival.
Topics: Aortic Valve; Cardiac Surgical Procedures; Female; Hospital Mortality; Humans; Hypoplastic Left Heart Syndrome; Infant, Newborn; Male; Mitral Valve Stenosis; Palliative Care
PubMed: 20971272
DOI: 10.1016/j.athoracsur.2010.06.113 -
Cardiology in the Young Mar 2016Mitral atresia is commonly seen as a part of the spectrum of hypoplastic left heart syndrome, and it is usually associated with multiple levels of systemic outflow tract...
Mitral atresia is commonly seen as a part of the spectrum of hypoplastic left heart syndrome, and it is usually associated with multiple levels of systemic outflow tract obstruction. Isolated mitral atresia with a normal aortic valve is extremely rare. We report the rare combination of mitral atresia, transposition of the great arteries, and unobstructed systemic and pulmonary blood flow.
Topics: Aortic Valve; Arteries; Echocardiography; Hemodynamics; Humans; Infant; Male; Mitral Valve; Transposition of Great Vessels
PubMed: 26394988
DOI: 10.1017/S1047951115001596