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 insufficiency of the regurgitant flow at the level of the valve. This is known as the regurgitant orifice area, and correlates with the size of the defect in the mitral valve. One particular echocardiographic technique used to measure the orifice area is measurement of the proximal isovelocity surface area (PISA). The flaw of using PISA to determine the mitral valve regurgitant orifice area is that it measures the flow at one moment in time in the cardiac cycle, which may not reflect the average performance of the regurgitant jet. The treatment of mitral insufficiency depends on the acuteness of the disease