Abstract

The causes of mitral insufficiency are primarily considered from an anatomic point of view. Mitral insufficiency may result from anatomic alteration of the papillary muscles, the chordae tendineae, the valve leaflets and/or the commissures. Left ventricular enlargement may contribute to mitral insufficiency by (1) enlargement of the valvular orifice and (2) alteration of the relationships between the valve leaflets, on one hand, and the chordae and papillary muscles, on the other. Left atrial dilatation resulting from one of the foregoing reasons for mitral insufficiency may displace the posterior leaflet and accentuate the degree of mitral insufficiency. Specific problems concerned with persistent common atrioventricular canal are also considered.

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