Key result
Multiphase 3D TEE identifies obscured accessory mitral valve tissue to facilitate successful surgical repair.
Why the study?
Congenital mitral valve abnormalities exhibit considerable anatomical variability and may be challenging to delineate using conventional echocardiographic views.
Case Report (n=1)
No
Systematic 3-dimensional transesophageal echocardiography using multiphase and left ventricular perspectives can identify complex congenital mitral valve abnormalities, such as accessory mitral valve tissue, that are obscured on conventional systolic surgeon's views.
Answers are grounded in this paper and cite their sources.
May aid preoperative planning in complex mitral regurgitation; leaves open whether multiphase 3D echo improves outcomes in broader populations.
BACKGROUND: Congenital mitral valve abnormalities exhibit considerable anatomical variability and may be challenging to delineate using conventional echocardiographic views. CASE SUMMARY: A man in his 50s with mitral regurgitation since childhood presented with exertional dyspnea and severe primary mitral regurgitation. Three-dimensional transesophageal echocardiography revealed extensive prolapse of congenitally connected P2-P3 scallops because of multiple chordal ruptures. A small leaflet-like structure was obscured on the conventional systolic surgeon's view but was identified during diastole and from the left ventricular perspective. Surgical inspection confirmed accessory mitral valve tissue. Mitral valve repair successfully controlled the regurgitation while preserving the accessory tissue. DISCUSSION: Conventional systolic imaging alone was insufficient to delineate the mitral valve anatomy. Multiphase imaging from complementary perspectives enabled recognition and characterization of the anomalous structure. TAKE-HOME MESSAGE: Systematic 3-dimensional assessment beyond the conventional systolic surgeon's view may facilitate recognition of otherwise overlooked mitral valve abnormalities.
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Nishino et al. (2026) conducted a case report in Severe primary mitral regurgitation with congenital mitral valve abnormality (congenitally connected P2-P3 scallops and accessory mitral valve tissue) (n=1). Three-dimensional transesophageal echocardiography and surgical mitral valve repair vs. Conventional systolic surgeon's view was evaluated on Recognition of accessory mitral valve tissue and control of mitral regurgitation. Multiphase 3D transesophageal echocardiography identified accessory mitral valve tissue obscured on conventional systolic imaging in 1 man in his 50s, facilitating successful valve repair.
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