The mitral valve (MV) plays a crucial role in cardiac function, controlling blood flow between the left atrium and left ventricle. The components of the valve include an anterior leaflet, a posterior leaflet, tendinous chords, papillary muscles, and a saddle shaped annulus at the atrioventricular junction.[1] Deviation in the morphology of any of these components of the valve may result in comprised mechanical integrity of the valve and abnormal leaflet closure.[1] With studies suggesting that the MV is an active, dynamic structure that is susceptible to treatment, it is imperative to understand the types of diseases associated with these functional changes.[2]
Mitral stenosis (MS) following mitral valve (MV) repair surgery for non-rheumatic regurgitant valvular heart disease is a pathology that is poorly understood. Currently, functional MS is defined as a mean transmitral pressure gradient (TMPG) of >5 mmHg or a mitral valve area (MVA) 0.9cm2/m2, at exercise and not at rest, proved to be an independent predictor of functional capacity and outcome. The anterior leaflet opening angle (α) at peak exercise was the strongest determinant of EOAi.[3]
Kubota et al. [12] in 2010 found that the anterior leaflet opening angle was an independent contributor to the leaflet tip opening length, which in itself, was…