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Case Reports
. 2021 Feb;116(2 suppl 1):36-38.
doi: 10.36660/abc.20190485.

Three-dimensional Echocardiography Reveals the True Enemy in a Young Male with ST-Elevation Myocardial Infarction and Severe Mitral Regurgitation: Posterior Mitral Valve "Pseudo-Cleft" and Prolapse

[Article in English, Portuguese]
Sorina Mihaila  1 , Andreea Elena Velcea  1 , Luigi Paolo Badano  2   3 , Vinereanu Dragos  1 , Denisa Muraru  2   3
Affiliations
Case Reports

Three-dimensional Echocardiography Reveals the True Enemy in a Young Male with ST-Elevation Myocardial Infarction and Severe Mitral Regurgitation: Posterior Mitral Valve "Pseudo-Cleft" and Prolapse

[Article in English, Portuguese]
Sorina Mihaila et al. Arq Bras Cardiol. 2021 Feb.
No abstract available

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Conflict of interest statement

Potencial conflito de interesses

Declaro não haver conflito de interesses pertinentes.

Figures

Figura 1
Figura 1. Avaliação morfológica tridimensional da valva mitral (abordagem transesofágica). Painel A) “Visão cirúrgica” da valva mitral fechada, do lado do átrio esquerdo, que mostra o prolapso complexo dos escalopes P2-3. O folheto anterior da valva mitral tem morfologia normal. Painel B) Abertura da valva mitral revela que o segmento P1 está separado dos segmentos P2-3, levantando a suspeita de uma pseudo-fenda. Painel C) Valva mitral visualizada do lado do ventrículo esquerdo. A pseudo-fenda do folheto posterior da valva mitral, entre os segmentos P1 e P2-3, pode ser identificada. AE: átrio esquerdo, Ao: aorta, RM: regurgitação mitral, VA: valva aórtica, VE: ventrículo esquerdo, VMA: valva mitral anterior, VSVE: via de saída do ventrículo esquerdo.
Figura 2
Figura 2. Avaliação bi- e tridimensional em cores da regurgitação mitral (abordagem transesofágica). Painel A) A valva mitral, visualizada a 85 graus, mostra os dois componentes da regurgitação mitral, causada pelo prolapso e pela pseudo-fenda. Painel B) A visão de eixo longo dos escalopes A2/P2 mostra o jato da regurgitação mitral causado pelo prolapso de P2, oposto ao escalope. Painel C) A “visão cirúrgica” da valva mitral mostra a origem ampla do jato da regurgitação mitral, visto do átrio esquerdo, que é direcionado anteriormente (são exibidos apenas os fluxos retrógrados). Ao: aorta; RM: regurgitação mitral, VA: valva aórtica, VMA: valva mitral anterior, VMP: valva mitral posterior.
Figure 1
Figure 1. Three-dimensional morphological assessment of the mitral valve (transesophageal approach). Panel A. “Surgical view” of the closed mitral valve, seen from the left atrial side, which shows a complex prolapse of the P2-3 scallops. The anterior mitral valve leaflet shows normal morphology. Panel B. Opening of the mitral valve reveals that the P1 segment is separated from the P2-3 segments, raising the suspicion of a pseudo-cleft. Panel C. The mitral valve visualized from the left ventricular side. The pseudo-cleft of the posterior mitral valve leaflet, between the P1 and the P2-3 segments, can be identified. AMV: anterior mitral valve; Ao: aorta; AoV: aortic valve; LA: left atrium; LV: left ventricle; LVOT: left ventricular outflow tract.
Figure 2
Figure 2. Two- and three-dimensional color assessment of the mitral regurgitation (transesophageal approach). Panel A. The mitral valve, visualized at 85 degrees, shows the two components of the mitral regurgitation, caused by the prolapse and the pseudo-cleft. Panel B. Long-axis view throughout the A2/P2 scallops shows the mitral regurgitation jet caused by the prolapse of P2, opposite the scallop. Panel C. The “surgical view” of the mitral valve shows the wide origin of the mitral regurgitation jet, seen from the left atrium, which is directed anteriorily (only retrograde flows are displayed). AMV: anterior mitral valve, Ao: aorta, AoV: aortic valve, MR: mitral regurgitation, PMV: posterior mitral valve.
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