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What are the anterior mitral valve echocardiographic findings in patients with isolated ventricular septal defect and tetralogy of Fallot?
What are the anterior mitral valve echocardiographic findings in patients with isolated ventricular septal defect and tetralogy of Fallot?
Echocardiography in patients with VSD and Tetralogy of Fallot may reveal low-amplitude, high-frequency fluttering of the anterior mitral leaflet during diastole, likely due to abnormal blood flow dynamics.
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May associate with right-to-left shunts on mitral echo in VSD/TOF; hypothesis-generating, requires validation before any diagnostic role.
Eight patients with isolated ventricular septal defect and two patients with tetralogy of Fallot were studied by UCG. Two of these patients showed notchings and five showed flutterings on F-A portions of the anterior mitral leaflet echoes. Fluttering seemed to be recorded more frequently in patients with right-to-left shunts such as cyanotic tetralogy of Fallot. It was considered that these functional changes of mitral valve echoes during diastole would be caused by the direction and amounts of blood flow across the defect and the velocity and amounts of blood flow through the mitral valve. Fluttering of mitral valve echo during diastole may be observed in normal subjects or in patients with other cardiac abnormalities, such as aortic insufficiency, atrial fibrillation or flutter. Flutterings seen in ventricular septal defect and tetralogy of Fallot are, however, of low amplitudes and of high frequencies, and are observed mainly between F and A points.
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Oki et al. (1975) studied this question.
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