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Review
. 2015 Sep 1;2(3):R63-72.
doi: 10.1530/ERP-15-0008. Epub 2015 Jul 7.

Quantitative mitral valve anatomy and pathology

Madalina Garbi  1 , Mark J Monaghan  1
Affiliations
Review

Quantitative mitral valve anatomy and pathology

Madalina Garbi et al. Echo Res Pract. .

Abstract

Quantitative analysis is an important part of the morphological assessment of the diseased mitral valve. It can be used to describe valve anatomy, pathology, function and the mechanisms of disease. Echocardiography is the main source of indirect quantitative data that is comparable with direct anatomic or surgical measurements. Furthermore, it can relate morphology with function. This review provides an account of current mitral valve quantification techniques and clinical applications.

Keywords: 3D; echocardiography; mitral valve; morphology; quantification; repair.

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Figures

Figure 1
Figure 1
Papillary muscle to annulus plane (red continuous line) distances (red dotted lines).
Figure 2
Figure 2
Normal annulus saddle shape. A, anterior; P, posterior; Ao, aortic valve; PM, postero-medial; AL, antero-lateral.
Figure 3
Figure 3
Normal annulus saddle and relative position of the papillary muscle tips. A, anterior; P, posterior; Ao, aortic valve; PM, postero-medial; AL, antero-lateral.
Figure 4
Figure 4
Predominant P2 prolapse.
Figure 5
Figure 5
Lone P2 prolapse.
Figure 6
Figure 6
3D model of the valve in Fig. 5 (lone P2 prolapse). A, anterior; P, posterior; Ao, aortic valve; PM, postero-medial; AL, antero-lateral.
Figure 7
Figure 7
3D model of the valve in Fig. 4 (predominant P2 but also more extensive prolapse of the posterior leaflet and commissures). A, anterior; P, posterior; Ao, aortic valve; PM, postero-medial; AL, antero-lateral.
Figure 8
Figure 8
3D model of Barlow valve with extensive prolapse.
Figure 9
Figure 9
The 3D model from Fig. 8 displayed to reveal leaflet atrialisation.
Figure 10
Figure 10
TOE 2D images (MPR) derived from the 3D dataset at Fig. 5 demonstrating single scallop prolapse and otherwise thin, normal leaflets not billowing above the annulus plane (red dotted line).
Figure 11
Figure 11
TOE 2D images (MPR) derived from the 3D dataset of the valve from Fig. 8 for an alternative demonstration of leaflet atrialisation, with extensive billowing above the annulus plane (red dotted line).
Figure 12
Figure 12
Tenting area.
Figure 13
Figure 13
Tethering angles in valve with bent anterior leaflet. Red dotted lines define the annulus plane and the plane of the proximal anterior leaflet, and red continuous lines define the distal anterior leaflet and the posterior leaflet.
See this image and copyright information in PMC

References

    1. Chikwe J Adams DH Su KN Anyanwu AC Lin HM Goldstone AB Lang RM Fischer GW Can three-dimensional echocardiography accurately predict complexity of mitral valve repair? European Journal of Cardio-Thoracic Surgery 41 2012. 518–524.10.1093/ejcts/ezr040 - DOI - PubMed
    1. Adams DH Anyanwu AC The cardiologist's role in increasing the rate of mitral valve repair in degenerative disease Current Opinion in Cardiology 23 2008. 105–110.10.1097/HCO.0b013e3282f4fe47 - DOI - PubMed
    1. Lang RM Salgo IS Anyanwu AC Adams DH The road to mitral valve repair with live 3D transesophageal echocardiography Medicamundi 52 2008. 37–42.
    1. Adams DH Rosenhek R Falk V Degenerative mitral valve regurgitation: best practice revolution European Heart Journal 31 2010. 1958–1967.10.1093/eurheartj/ehq222 - DOI - PMC - PubMed
    1. Shanks M Delgado V Ng ACT van der Kley F Schuijf JD Boersma E van de Veire NRL Nucifora G Bertini M de Roos A et al. Mitral valve morphology assessment: three-dimensional transesophageal echocardiography versus computed tomography Annals of Thoracic Surgery 90 2010. 1922–1929.10.1016/j.athoracsur.2010.06.116 - DOI - PubMed

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