Double-Orifice Mitral Valve in an Adult with Atrioventricular Reentrant Tachycardia

Figures

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  Figure 1. Electrocardiogram showing sinus rhythm without delta waves.

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  Figure 2. Event monitor strip showing wide-QRS tachycardia with left bundle branch block configuration transitioning to narrow-QRS tachycardia at similar cycle length, highly suggestive of an atrioventricular reentrant tachycardia with a left-sided accessory pathway.

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  Figure 3. Transthoracic echocardiogram, apical two-chamber view, without Doppler, showing DOMV with a tissue bridge at the level of the mitral valve annulus, indicating a complete bridge-type DOMV.

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  Figure 4. Transthoracic echocardiogram, short-axis view (off-axis) without Doppler, showing two well-defined circular mitral valves divided by a tissue bridge, confirming the complete bridge-type DOMV.

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  Figure 5. Transesophageal echocardiogram, midesophageal long-axis (off-axis) view in diastole (left) and systole (right), without Doppler, providing further characterization of the DOMV.

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  Figure 6. Cardiac magnetic resonance imaging of DOMV.

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  Figure 7. Transthoracic echocardiogram, apical four-chamber view, pulsed-wave Doppler of mitral valve inflow, showing mild mitral regurgitation without evidence of mitral stenosis. Mitral valve mean peak gradient is 3 mm Hg.

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  Figure 8. Transesophageal echocardiogram, midesophageal short-axis view, showing bicuspid aortic valve.