Key result
A combination of 2-D and 3-D transesophageal echocardiography successfully identified a complex mitral valve lesion involving both P2 prolapse and a cleft between P2 and P3, guiding the surgical repair strategy.
Why the study?
A mitral cleft can be an important etiological factor for significant mitral regurgitation, and its diagnosis can affect surgical procedures.
Case Report (n=1)
No
The combination of 2-D and 3-D TEE is useful for diagnosing complex mitral valve lesions such as a cleft, which can significantly impact the choice of surgical repair technique.
May inform repair planning in select complex mitral cases; leaves open need for prospective validation.
BACKGROUND: A mitral cleft may be an important etiological factor for significant mitral regurgitation. We diagnose an additional cleft mitral valve by a combination of 2-dimensional (2-D) and 3-dimensional (3-D) echocardiography. CASE PRESENTATION: We describe the case of a severe mitral regurgitation due to posterior leaflet prolapse (P2). In the 2-D view, which is obtained after turning the probe clockwise from the mid-esophageal long-axis view, TEE showed a moderate central regurgitation jet. In the 3-D en face view, a cleft between P2 and P3 was identified, and we found that the cause of mitral regurgitation was not only P2 prolapse but also a cleft between P2 and P3. CONCLUSION: A complex mitral valve lesion was detected by a combination of 2-D and 3-D TEE. The presence of a cleft could affect the surgical procedure because of the possibility that an enlarged cleft would increase with leaflet resection.
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Miyata et al. (2020) conducted a case report in Severe mitral regurgitation due to posterior leaflet prolapse and cleft mitral valve (n=1). Combination of 2-D and 3-D transesophageal echocardiography was evaluated on Diagnosis of complex mitral valve lesion. A combination of 2-D and 3-D transesophageal echocardiography successfully identified a complex mitral valve lesion involving both P2 prolapse and a cleft between P2 and P3, guiding the surgical repair strategy.
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