The clinical anatomy of the mitral valve.

As a result of the numerous clinical and surgical data accumulated so far, the classical image of the mitral valve-a bicuspid valve, with two leaflets and two papillary muscles-undergoes significant modifications. The valve, included into the larger concept of the mitral valvular complex unveils numerous important valences and characteristics, among which, some represent newer concepts, of clinical and surgical significance: the valvular complex is a subtle and finely-tuned system of elements acting in a coordinated manner; the mitral valve is an active valve and not a mere passive flap bordering the atrioventricular junction. Not least, the mitral valve contributes to the make up and function of the left ventricular outflow tract. The anatomical and functional interdependence between the mitral valve and the left ventricular myocardium is evident not only following their particularities of vascularization but also it is reflected in morbid states such as ischemic cardiac disease and dilated cardiomyopathy. All the new concepts and ideas, ask for a more profound study of the clinical anatomy of the mitral valve, underscoring the importance of a pertinent dialogue between specialists and by using a more appropriate and unitary terminology. (c) 2008 Wiley-Liss, Inc.