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>Journals >Cirugía y Cirujanos >Year 2004, Issue 5

Rosas-Munive E, Valenzuela-Flores GA, Valenzuela-Flores AA
Mitral valve prolapse. A review
Cir Cir 2004; 72 (5)

Language: Español
References: 49
Page: 415-420
PDF: 71.09 Kb.

Full text


Primary mitral valve prolapse (MVP) or the disease known as MVP, consists of mixomatous degeneration of the mitral valve with systolic displacement of a portion or all of one or both mitral leaflets beyond mitral annulus into left atrium during systole, associated or not with mitral insufficiency. Prevalence in Mexican population is <2%. MVP behavior is benign unless associated with mitral insufficiency (MI, moderate-to-severe) or complications, or is associated with other syndromes. The major clinical feature of mitral valve prolapse syndrome is mid-to-late systolic clicks identified with auscultation of mitral valve. Echocardiography is usually employed for diagnosis and management. Two-dimensional echocardiography displays one or both leaflets prolapsing behind mitral annulus and into left atrium in systole. In the majority of cases, MVP is harmless and does not cause symptoms nor does it need to be treated. In a small number of cases, it can cause severe mitral regurgitation and needs surgical treatment. Complications derived from MVP must be treated independently. Secondary MVP also consist of displacement of one or both valves toward atrium, but this is due to pathologies such as rheumatic heart disease, ischemic heart disease, or others. In these situations, treatment will be that of the underlying diseases.

Key words: Prolapse, Mitral valve.


  1. Barlow JB, Marchand P, Pocock WA, Denny D. The significance of late systolic murmurs. Am Heart J 1963;66:443.

  2. Barlow JB, Bosman CK, Cochran JW. Congenital cardiac arrhythmia. Lancet 1964;II:531.

  3. Barlow JB. Conjoint clinic on the clinical significance of late systolic murmurs and non-ejection systolic clicks. J Chronic Dis 1965;18:666-673.

  4. Humphries JO, McKusick VA. The differentiation of organic and “innocent” systolic murmurs. Prog Cardiovasc Dis 1962;5:152-171.

  5. Criley JM, Lewis KB, Humphries JO, Ross RS. Prolapse of the mitral valve: clinical and cine-angiographic findings. Br Heart J 1966;28:488-496.

  6. Barlow JB, Bosman CK. Aneurismal protrusion of the posterior leaflet of the mitral valve: an auscultatory-electrocardiographic syndrome. Am Heart J 1966;71:166-178.

  7. Cheng TO, Barlow JB. Mitral leaflet billowing and prolapse: its prevalence around the world. Angiology 1989;40:77-87.

  8. Hickey A, Wilcken D. Prevalence of mitral valve prolapse in an Australian population. Lancet 1980;1(8182) :1366.

  9. Stefanadis C, Toutouzas P. Mitral valve prolapse. The Merchant of Venice or much ado about nothing? Eur Heart J 2000;21:255-258.

  10. Cabeen WR, Reza MJ, Kovick RB, Stern MS. Mitral valve prolapse and conduction defects in Ehlers-Danlos syndrome. Arch Intern Med 1977;137:1227.

  11. Lebwohl MG, Distefano D, Prioleau PG. Pseudoxantoma elasticum and mitral valve prolapse. N Engl J Med 1982;302:228.

  12. Jaffe AS. Geltman EM, Rodey GE, Uitto J. Mitral valve prolapse: a consistent manifestation of type IV Ehlers-Danlos syndrome. The pathogenetic role of the abnormal production of type III collagen. Circulation 1981;64:12.

  13. King BD, Clark MA, Baba N. Myxomatous mitral valve prolapse. Collagen dissolution as the primary defect. Circulation 1982;66:288.

  14. Nascimento R, Freitas A, Teixeira F, Pereira D, Cardoso A, Dinis M, et al. Is mitral valve prolapse a congenital or acquired disease? Circulation 1997;79(2):226-227.

  15. Datos no publicados.

  16. Braunwald E. Valvular heart disease. In: Braunwald’s heart disease: a textbook of cardiovascular medicine. 5th ed. Saunders Co; 1997. pp. 1029-1035.

  17. Zuppiroli A, Roman M, O’Grady M, Deveraux R. A family study of anterior mitral leaflet thickness and mitral valve prolapse. Am J Cardiol 1998; 82:823-826.

  18. Pan CW, Chen CC, Wang SP. Echocardiographic study of cardiac abnormalities in families of patients with Marfan’s syndrome. J Am Coll Cardiol 1985;5:1016.

  19. Devereaux R, Brown T, Lutas E, Kramer R, Laragh J. Association of mitral valve prolapse with low body weight and low blood pressure. Lancet 1982;2(8302):792-795.

  20. Deveraux R, Brown W, Lutas E, Kramer F, Laragh J. Mitral valve prolapse and blood pressure. Lancet 1983;1(8320):366.

  21. Fishleder B, Chávez I. Exploración cardiovascular y fonomecanocardiografía clínica. México, D.F.: La Prensa Médica Mexicana; 1966.

  22. Pedersen H, Häggstrom J. Mitral valve prolapse in the dog of mitral valve prolapse in man. Cardiovasc Res 2000;47:234-243.

  23. Stein K, Borer J, Hochreiter C, et al. Prognostic value and physiological correlates of heart rate variability in chronic severe mitral regurgitation. Circulation 1993;83:397.

  24. Wit A, Fenoglio J, Hordof A, Reemtsma K. Ultrastructure and transmembrane potentials of cardiac muscle in the human anterior mitral valve leaflet. Circulation 1979;59:1283.

  25. Ohki R, Yamamoto K, Okayama M, Nonaka M, Suzuki C, Ikeda U, Shimada K. The site of mitral valve prolapse is a predictor of atrial fibrillation. Am J Cardiol 2001;88:811-813.

  26. Rosas ME. Ecocardiografía, metodología, diagnóstico y aplicación clínica. 1ª ed. México, D.F.: El Manual Moderno; 2003.

  27. Cho L, Gillinov M, Cosgrove D, Griffin B, García M. Echocardiographic assessment of the mechanism of correction of bileaflet prolapse causing mitral regurgitation with only posterior leaflet repair surgery. Am J Cardiol 2000;86:1349-1351.

  28. Grossman G, Giesler M, Stein M, Kochs M, Höher M, Hombach V. Quantification of mitral and tricuspid regurgitation by the proximal flow convergence using two-dimensional color Doppler and color Doppler M-mode: influence of the mechanism of regurgitation. Int J Cardiol 1998;66:299-307.

  29. De Simone R, Glombitza G, Friederich C, Albers J, Meinzer H, Hagl S. Assessment of mitral regurgitated jets by three-dimensional color Doppler. Ann Thorac Surg 1999;67:494-499.

  30. Binder T, Moertl D, Mundigler G, Rehak G, Franke M, Delle-Karth G, et al. Stereolithographic biomodeling to create tangible hard copies of cardiac structures form echocardiographic data. J Am Coll Cardiol 1999;35:230-237.

  31. Berger A, Gottdiener J, Yohe M, Guerrero J. Epidemiological approach to quality assessment in echocardiographic diagnosis. J Am Coll Cardiol 1999;34:181-186.

  32. Louie E, Langholz D, Mackin W, Wallis D, Jacobs W, Scanlon P. Transesophageal echocardiographic assessment of the contribution of intrinsic thickness in the appearance of a thick mitral valve in patients with mitral valve prolapse. J Am Coll Cardiol 1996;28:465-471.

  33. Mills W, Barber E, Skiles J, Ratliff N, Cosgrove D, Vesely I, Griffin B. Clinical, echocardiographic, and biomechanical differences affecting one or both leaflets. Am J Cardiol 2002;89:1394-1399.

  34. Spencer F, Galloway A, Grossi E, Ribakove G, Delianides J, et al. Recent developments and evolving techniques of mitral valve reconstruction. Ann Thoracic Surg 1998;65:307-313.

  35. Ming Lee T, Su SF, Huang TY, Chen MF, Liau CS, Lee YT. Excessive papillary muscle traction and dilated mitral annulus in mitral valve prolapse without mitral regurgitation. Am J Cardiol 1996;78:482-485

  36. Hisatomi K, Isomura T, Sato T, Kosuga K, Ohishi K, Katoh H. Mitral valve repair for mitral regurgitation with ventricular septal defect in children. Ann Thoracic Surg 1996;62:1773-1777.

  37. Gregori F, Cordeiro C, Croti U, Hayashi S, Da Silva S, Gregori T. Partial tricuspid valve transfer for repair of mitral insufficiency due to ruptures of chordae tendinae. Ann Thorac Surg 1999;68:1686-1691.

  38. Gillinov A, Cosgrove D, Wahi S, Stewart W, Lythle B, Smedira N, et al. Is anterior leaflet repair always necessary in repair of bileaflet valve prolapse? Ann Thorac Surg 1999;68:820-824.

  39. Yu E, Omran A, Wigle D, Williams W, Siu S, Rakowski H. Mitral regurgitation in hypertrophic obstructive cardiomyopathy: relationship to obstruction and relief with myomectomy. J Am Coll Cardiol 2000;36:2219-2225.

  40. Dreyfus G, Bahrami T, Mihealainu S, Dubois C, Lentdecker P. Repair of anterior leaflet prolapse by papillary muscle repositioning: a new surgical option. Ann Thorac Surg 2001;71:1464-14670.

  41. Shroeyes P, Wellens F, De Geest R, Degrieck I, Van Praet F, Vermeulen Y, Vanemen H. Minimally invasive video-assisted mitral valve surgery: our lessons after a 4-year experience. Ann Thorac Surg 2001;72:S1050-S1054.

  42. Phillips M, Daly R, Scaf H, Dearani J, Mullay C, Orszulak T. Repair of anterior leaflet mitral valve prolapse: chordal replacement versus chordal shortening. Ann Thorac Surg 2000;69:25-29.

  43. Gorman J, Gorman R, Jackson B, Hiramatsu Y, Gikakis N, Kelley S, et al. Distortions of the mitral valve in acute ischemic mitral regurgitation. Ann Thorac Surg 1997;64:1026-1031.

  44. Blase C, Crawford F. Medical progress: valvular heart disease. N Engl J Med 1997;337:32-41.

  45. ACC/AHA Guidelines for the Management of Patients with Valvular Heart Disease. ACC/AHA Task Force Report. J Am Coll Cardiol 1998;32:1486-1488.

  46. Kimura B, Scott R, Willis C, De Maria A. Accuracy and cost-effectiveness of single view echocardiographic screening for suspected mitral valve prolapse. Am J Med 2000;108:331-333.

  47. Benjamin E. Mitral valve prolapse: past misconceptions and future research directions. Am J Med 2001;111:726-728.

  48. Fat Tse H, Lau C, Cheng G. Relation between mitral regurgitation and platelet activation. J Am Coll Cardiol 1997;30:1813-1818.

  49. Kostuk W, Bougjmer DR, Barnett HJ, Silver MD. Strokes complication of mitral leaflet prolapse. Lancet 1977;8033:313-316.

>Journals >Cirugía y Cirujanos >Year 2004, Issue 5

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