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. 2012 Jan;5(1):3-12.
doi: 10.4103/0974-2069.93703.

Congenital mitral valve lesions : Correlation between morphology and imaging

Bo Remenyi  1 , Tom L Gentles
Affiliations

Congenital mitral valve lesions : Correlation between morphology and imaging

Bo Remenyi et al. Ann Pediatr Cardiol. 2012 Jan.

Abstract

Congenital malformations of the mitral valve are often complex and affect multiple segments of the valve apparatus. They may occur in isolation or in association with other congenital heart defects. The majority of mitral valve malformations are not simply classified, and descriptive terms with historical significance (parachute, mitral, or arcade) often lack the specificity that cardiac surgeons demand as part of preoperative echocardiographic morphological assessment. This paper examines the strengths and limitations of commonly used descriptions and classification systems of congenitally malformed mitral valves. It correlates pathological, surgical, and echocardiographic findings. Finally, it makes recommendations for the systematic evaluation of the congenitally malformed mitral valve using segmental echocardiographic analysis to assist precise communication and optimal surgical management.

Keywords: Congenital; echocardiography; mitral valve.

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Conflict of interest statement

Conflict of Interest: None declared.

Figures

Figure 1
Figure 1
Video 1(a–d): Mixed congenital mitral regurgitation and stenosis. The mitral annuls is markedly dilated. The leaflets are thickened and dysplastic. The chords are abnormally short and fused. The anterolateral papillary muscle (*) inserts high, just below the level of the annulus
Figure 2
Figure 2
Video 2(a–d) Supramitral ring. The fibrous ring (arrows) is an integral part of the anterior and posterior mitral valve leaflets. The leaflet tips are thickened and chords are abnormally short. (a) 2-D TEE, (b) 2-D color TEE, (c) 3-D live, and (d) 3-D full volume acquisition
Figure 3
Figure 3
Video 3: Live 3-D transthoracic image of an anterior mitral valve leaflet cleft, left ventricular view
Figure 4
Figure 4
Video 4a–b: Double orifice mitral valve, transthoracic 2-D images. (a) Apical-four-chamber view. (b) Parasternal-short-axis-view. Arrows points to the two separate suborifices each supported by its own chordal apparatus
Figure 5
Figure 5
Video 5: Live 3-D transthoracic image of posterior mitral valve leaflet prolapse, left atrial view. The smaller solid points to a flail posterior medial (P1) segment and the larger arrow points to the middle scallop (P2 segment) prolapse
Figure 6
Figure 6
Video 6: Parachute mitral valve, transthoracic 2-D parasternal-short-axis-views. The arrow points to the single hypertrophied posteromedial papillary muscle. Note the eccentric opening of the mitral valve orifice
See this image and copyright information in PMC

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