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 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