The mitral valve is a complex, specialised connective tissue structure which acts to maintain the forward flow of blood through the left side of the heart. The mitral valve consists of two leaflets, with numerous supporting chordae tendineae. The mitral valve leaflets have a layered structure, with the structural constituents of each layer determined by its functional role. Evidence suggests that the valvular interstitial cells (VICs) which are present within the connective tissue layers of the mitral valve play an active role in mitral valve dynamics, a theory enhanced by the observation of neural structures within the valve tissue. Disease of the heart valves, such as myxomatous mitral valve disease, has been associated with changes in the phenotype of valvular cells and composition of the valvular extracellular matrix (ECM), and continues to have a devastating impact worldwide. Despite valve repair being the preferred initial treatment method to address severe mitral valve disease, valve repair is not feasible in a large number of patients with end-stage valve disease, and replacement of the mitral valve with a biological or mechanical prosthesis is necessary. A number of limitations are associated with conventional prosthetic mitral valves, however, including thromboembolism, life-threatening haemorrhagic complications, limited durability, rejection and transmission of infection. To overcome these limitations, the focus of prosthetic valve research has shifted to the development of living valves with growth and remodelling capabilities through tissue engineering, with many animal studies demonstrating the feasibility of this approach. The present chapter provides a comprehensive review on the development and structure of the mitral valve, particularly relating to its connective tissue and cellular components, while morphological and histological changes in this structure associated with mitral valve disease are also discussed. Potential future treatment modalities for pathological mitral valve disease using tissue-engineered structures are also discussed.
|Title of host publication||Advances in Cardiovascular Research, Vol 1|
|Editors||L. Schmitt, T. Konig|
|Place of Publication||Hauppauge, NY|
|Publisher||Nova Science Publishers Inc|
|Number of pages||45|
|Publication status||Published - 1 Jan 2010|
|Name||Advances in Cardiovascular Research|