Mitral valve stenosis ) can cause a precipitous decrease in cardiac output and sudden congestive heart failure. Patients with mitral stenosis prompts a series of hemodynamic changes that frequently cause deterioration of the patient's clinical status. A reduction in cardiac output, associated with acceleration of heart rate and shortening of the diastolic time, frequently leads to congestive heart failure. In addition, when AF sets in, systemic embolization becomes a real danger. Mitral stenosis typically progresses slowly (over decades) from the initial signs of mitral stenosis to NYHA functional class II symptoms to the development of atrial fibrillation to the development of NYHA functional
Mitral valve annuloplasty the cardiac cycle. These changes are primarily due to the dynamic motion of the surrounding mitral valve annulus, a collageneous structure which attaches the mitral leaflets and the left atrium to the ostium of the left ventricle and the aortic root. Throughout the cardiac cycle, the annulus undergoes a sphincter motion, narrowing down the orifice area during systole to facilitate coaptation of the two leaflets and widens during diastole to allow for easy diastolic filling of the left ventricle. This motion is further enhanced by a pronounced three-dimensional configuration during systole, the characteristic saddle shape. These changes throughout the cycle