Mitral valve annuloplasty double by the year 2030. Every year, 300,000 people worldwide undergo open heart surgery for mitral valve repair, 44,000 people in the US alone. Since it was initially established 40 years ago by Professor Alain Carpentier, mitral valve annuloplasty has been continuously improved and is considered the gold standard for the treatment of most etiologies of mitral valve dysfunction today. The goal of mitral valve annuloplasty is to regain mitral valve competence by restoring the physiological form and function of the normal mitral valve apparatus. Under normal conditions the mitral valve undergoes significant dynamic changes in shape and size throughout
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.