Original articleThe Added Value of Real-time 3-Dimensional Echocardiography in the Diagnosis of Isolated Cleft Mitral Valve in Adults
Section snippets
Methods
Our database included more than 45,000 echocardiographic examinations performed in adults between 1996 and 2004. Five patients (2 men, 3 women), with a mean age of 33 ± 9 years and with no previous surgical interventions, were diagnosed with isolated cleft mitral valve without associated heart disease.
All 5 patients were re-evaluated and detailed 2D and RT3D echocardiography was performed. Two-dimensional echocardiograms were performed using commercially available devices (Vivid 7, GE, Horten,
Results
On 2D echocardiography, diagnosis and measurement of the cleft width required careful and repeated analysis of the short-axis parasternal view at multiple valve levels. This technique revealed leaflet thickening; however, characterization of the full extent of fibrosis and retraction was not achieved. Accessory chordae were identified in 4 patients: one chorda was seen at its attachment to the septum and was characterized as being of chordal type, whereas the remaining chordae were visible but
Discussion
The anatomic aspects of cleft mitral valve without septal defects have been previously reviewed. 1, 5 The cleft usually involves the anterior leaflet, points toward the LVOT, and divides the leaflet into two portions. Anomalous chordal attachments to the septum or to the anterior wall, sometimes leading to subaortic obstruction, are a frequent finding. Mitral leaflets are smooth in younger patients, whereas cleft edge fibrosis increases with age. 1 Two-dimensional echocardiography facilitates
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