Mitral valve repair surgery is much more technically demanding and may involve higher risk. Occasionally, the mitral valve is abnormal from birth (congenital). More often the mitral valve becomes abnormal with age (degenerative) or as a result of rheumatic fever. In rare instances the mitral valve can be destroyed by infection or a bacterial endocarditis. Mitral regurgitation may also occur as a result of ischemic heart disease (coronary artery disease) or non-ischemic heart disease (dilated cardiomyopathy). In 1923 Dr. Elliott Cutler of the Peter Bent Brigham Hospital performed the world’s first successful heart valve surgery – a mitral valve "repair". The patient was
Mitral insufficiency MR and mitral valve prolapse are also common in Ehlers–Danlos syndromes. Secondary mitral insufficiency is due to the dilatation of the left ventricle that causes stretching of the mitral valve annulus and displacement of the papillary muscles. This dilatation of the left ventricle can be due to any cause of dilated cardiomyopathy including aortic insufficiency, nonischemic dilated cardiomyopathy, and Noncompaction cardiomyopathy. Because the papillary muscles, chordae, and valve leaflets are usually normal in such conditions, it is also called functional mitral insufficiency. Acute MR is most often caused by endocarditis, mainly "S. aureus". Rupture or dysfunction of the papillary muscle