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Structural Functional Mitral Regurgitation:: Echo Subleties Hallmarks
Structural Functional Mitral Regurgitation:: Echo Subleties Hallmarks
Structural Functional Mitral Regurgitation:: Echo Subleties Hallmarks
Mitral Regurgitation:
Echo Subleties and Hallmarks
Steven A. Goldstein, MD
Director, Noninvasive Cardiology
Washington Hospital Center
Sunday, February 21, 2010
The Mitral Apparatus
• Mitral leaflets
• Chordae tendinae
• Papillary muscles
• Mitral annulus
• Left ventricle
• Left atrium
Mitral Valve Anatomy
Dilatation Left atrium Dilatation
Calcification
Prolapse
Redundancy
Annulus Thickening
Perforation
Leaflets Cleft
Commissural fusion
Normal Prolapse
Apical
Tethering
Dilated anulus
• Ischemic/functional MR
Ruptured cords
Case 1
Ruptured cords P2
1.6 cm
+
.
.
.
+
Gastric short-axis view
(PSR view)
L-upper pulm vein
• Extent
• Dilatation/size of annulus
Case 2
Ruptured cord P2
Case 3
Ruptured cords A2 and A3
Surgeon’s roadmap A2 and A3
MVP
Case 4
Mitral Valve Prolapse
AML
S/P repair
Functional MR
Morphologic Changes in Heart Failure
B
C
A
MROP340
Apical Tethering of Mitral Leaflets
• Atrio-ventricular synchrony