Exploring the Operative Strategy for Secondary Mitral Regurgitation: A Systematic Review

Figure 2

(a–c) Apoptotic and fibrotic change involving mitral leaflets in secondary mitral regurgitation. The harmful effect is due to leaflets tethering mediated by transforming growth factor- (TGF-) β secondary PM displacement and traction. (b) Absence of leaflet thickness without profibrotic changes of tethered MV leaflets leads to integrity of mitral leaflet structure. (c) Mitral valve leaflet fibrosis post-MI is associated with excessive endothelial-to-mesenchymal transition driven by TGF-β overexpression. Evidence with profibrotic changes due to tethering of MV leaflet post-MI.