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Mitral annulus enlargement in mitral regurgitation: Look to the north

      Mitral regurgitation (MR) remains the most common valvular heart disease encountered in clinical practice. Clinically significant MR results from a diverse range of pathology, categorized into primary (degenerative) MR resulting from abnormalities of the mitral valve leaflets or secondary (functional) MR resulting from abnormalities of the left ventricle (LV) and/or mitral annulus. Patients with primary MR may have leaflet prolapse with or without a flail segment and can also display concomitant elements of secondary MR. Pure secondary MR has traditionally been attributed to LV enlargement and dysfunction that subsequently results in leaflet tenting, mitral annular enlargement and leaflet malcoaptation [
      • Nishimura R.A.
      • Vahanian A.
      • Eleid M.F.
      • Mack M.J.
      Mitral valve disease—current management and future challenges.
      ]. The mitral annulus, part of the fibrous cardiac skeleton, connects the left atrium (LA) with the LV and is intimately involved in pathologic conditions that may affect either of these chambers.
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      References

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        • Vahanian A.
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        Mitral valve disease—current management and future challenges.
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