Document Detail

Isolated mitral valve prolapse: chordal architecture as an anatomic basis in older patients.
MedLine Citation:
PMID:  3998315     Owner:  NLM     Status:  MEDLINE    
Ten patients with an average age of 58 years underwent valve replacement because of isolated mitral valve prolapse with severe regurgitation. None had clinical evidence of Marfan's syndrome or another systemic disease that would indicate that a primary connective tissue disorder was the cause of the prolapse. All 10 patients had a dome configuration of the posterior leaflet and one or more ruptured chordae related to it. The gross morphology of the resected specimens revealed marked deviations in chordal branching and the pattern of anchoring in each of the 10 cases, rendering the most severely affected parts of the leaflets less well supported. Similar changes occurred at sites remote from the principal abnormality. Microscopically, the dominant tissue change was myxomatous transformation within the affected leaflets and chordae with secondary changes at both atrial and ventricular surfaces. These findings could indicate that insufficient chordal support may have promoted the development of the floppy valve through a process of chronic undue and unbalanced stress on the valve tension and closure apparatus. The resultant degeneration of the connective tissues, histologically expressed as myxomatous transformation, may underlie stretching and thus redundance of the leaflets and eventually rupture of chordae. It is suggested that this sequence of events be considered as a possible pathogenetic mechanism of isolated mitral valve prolapse, particularly in the subset of aged patients.
J van der Bel-Kahn; D R Duren; A E Becker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  5     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1985 Jun 
Date Detail:
Created Date:  1985-07-10     Completed Date:  1985-07-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1335-40     Citation Subset:  IM    
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MeSH Terms
Age Factors
Chordae Tendineae / pathology*
Heart Valve Diseases / pathology
Heart Valve Prosthesis
Middle Aged
Mitral Valve / pathology*,  surgery
Mitral Valve Prolapse / pathology*,  surgery
Myocardium / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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