Mitral valve replacement cardiac surgery must be divided into pre-, intra- and postoperative. The incidence, phenomenology, and duration of symptoms diverge from patient to patient, and are difficult to define. One wonders whether any of the patients in either group in this analysis underwent any mechanical cardiac valve replacement. If so, one has to consider , described by Victor Skumin in 1978 as a “cardioprosthetic psychopathological syndrome” associated with mechanical heart valve implant and manifested by irrational fear, anxiety, depression and sleep disorder. A common postoperative complication with mitral valve surgery in a study involving 99 patients who had surgery for mitral regurgitation
Mitral valve prolapse "atrialis", "fibrosa", and "spongiosa". Patients with classic mitral valve prolapse have excess connective tissue that thickens the spongiosa and separates collagen bundles in the fibrosa. This is due to an excess of dermatan sulfate, a glycosaminoglycan. This weakens the leaflets and adjacent tissue, resulting in increased leaflet area and elongation of the chordae tendineae. Elongation of the chordae tendineae often causes rupture, commonly to the chordae attached to the posterior leaflet. Advanced lesions—also commonly involving the posterior leaflet—lead to leaflet folding, inversion, and displacement toward the left atrium. Echocardiography is the most useful method of diagnosing a prolapsed mitral valve.