The mitral annulus area: a useful tool for the surgeon.

The dimensions and dynamics of the mitral annulus play an important role in the pathophysiology of mitral insufficiency. Annuloplasty constitutes a primary step of surgical repair. Although considerable advances in cardiac imaging techniques have been made during recent years, in clinical practice the sizing of the mitral annulus is still not carried out prior to surgical mitral repair. This review is based on recently acquired knowledge of the normal and pathological dynamics of the annulus, and recommends the systematic preoperative measurement of the mitral annulus area.