Key result
3DE clearly visualizes a double-orifice mitral valve and central tissue bridge in a 14-year-old patient.
Case Report (n=1)
3D transthoracic echocardiography provides clear visualization of the functional anatomy of a double-orifice mitral valve, aiding in accurate diagnosis.
3D TTE may aid detection of rare congenital mitral anomalies in adolescents; leaves open its routine role pending larger studies.
A 14-year-old boy was referred to our echocardiography laboratory because of a recent history of palpitations. Both physical examination and ECG were unremarkable. An ambulatory ECG recording detected only rare supraventricular ectopic beats. A two-dimensional transthoracic echocardiogram (2DE, Panel A, see Supplementary data online, Video S1) raised the suspect of a double-orifice mitral valve (DOMV), without either stenosis or regurgitation at colour and spectral Doppler analyses (Panel B). Three-dimensional transthoracic echocardiography (3DE) visualization of the valve from both ventricular and atrial perspectives (Panels C and D, see Supplementary data online, Videos S2 and S3) clearly showed the double orifices (white *) with a central bridge of abnormal tissue connecting the anterior with the posterior leaflet. The two orifices were asymmetric, being the medial orifice slightly larger than the lateral one. Valvular leaflets were thin and normally sized. There were two papillary muscles that showed normal morphology and position. No other combined congenital abnormalities were detected. The patient was discharged without performing additional tests and no prescription. *, mitral valve orifice; AML, anterior mitral leaflet; AV, aortic valve; IAS, interatrial septal defect; LAA, left atrial appendage; PML, posterior mitral leaflet; RV, right ventricle. Supplementary data are available at European Heart Journal – Cardiovascular Imaging online.
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Ermacora et al. (2015) conducted a case report in Double-orifice mitral valve (n=1). Three-dimensional transthoracic echocardiography was evaluated on Visualization of functional anatomy of double-orifice mitral valve. Three-dimensional transthoracic echocardiography clearly visualized a double-orifice mitral valve with a central bridge of abnormal tissue in a 14-year-old boy with palpitations.
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