RT Book, Section A1 Schaff, Hartzell V. A1 Suri, Rakesh M. A2 Cohn, Lawrence H. A2 Adams, David H. SR Print(0) ID 1144165936 T1 Multiple Valve Disease T2 Cardiac Surgery in the Adult, 5e YR 2017 FD 2017 PB McGraw-Hill Education PP New York, NY SN 9780071844871 LK accesscardiology.mhmedical.com/content.aspx?aid=1144165936 RD 2024/04/20 AB Pathologic changes in the cardiac valves requiring surgical correction of more than one valve can result from rheumatic heart disease, degenerative valve diseases, infective endocarditis, and a number of other miscellaneous causes. Further, valve dysfunction may be primary; that is, a direct result of a disease process, or secondary; that is, caused by cardiac enlargement and/or pulmonary hypertension. Surgical management is influenced both by the underlying cause of valve dysfunction and, when valves are involved secondarily, by the anticipated response to replacement or repair of the primary valve lesion. In addition, the consequences of various combinations of diseased valves on left and right ventricular geometry and function frequently are different from the remodeling as a result of single-valve disease. This chapter addresses pathophysiologic considerations in multivalvular heart disease, surgical techniques, and management of commonly encountered etiologies.