#!/usr/bin/perl
use warnings;
use strict;
use feature qw{ say };

use XML::LibXML;

my @val;
my $doc = 'XML::LibXML'->load_xml( location => 'file.xml' );
for my $book ($doc->findnodes('/mdc/md/mi/mt[contains(.,"VAL")]')) {
    my $order = 1 + $book->findvalue('count(preceding-sibling::mt)');
    my $rs = $book->findnodes("../mv/r[$order]");
    say join ', ', map $_->textContent, $book, @$rs;
}