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Current concepts in mitral valve prolapse—Diagnosis and management

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Presentation on theme: "Current concepts in mitral valve prolapse—Diagnosis and management"— Presentation transcript:

1 Current concepts in mitral valve prolapse—Diagnosis and management
Pravin M. Shah, MD  Journal of Cardiology  Volume 56, Issue 2, Pages (September 2010) DOI: /j.jjcc Copyright © Terms and Conditions

2 Figure 1 Carpentier classification of mitral valve leaflet structure. The mitral valve is viewed from the left atrium. A: anterior; P: posterior. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

3 Figure 2 (A) Duran classification of mitral valve leaflet structure. A: anterior; PM: posterior middle; P1: posterior lateral; P2: posterior midial. (B) Modified Duran classification. A: anterior; P: posterior; PM: posterior middle (1=lateral, 2=medial). Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

4 Figure 3 Proposed new classification. The middle segments of both anterior (A2) and posterior (P2) leaflets are divided into lateral (L) and medial (M) halves. In addition the lateral and medial commissural scallops are also included (CL and CM, respectively). Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

5 Figure 4 Mitral leaflet anatomy as visualized by transesophageal echocardiography midesophageal transverse plane. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

6 Figure 5 Mitral leaflet anatomy as visualized by transesophageal echocardiography midesophageal long-axis plane. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

7 Figure 6 Measurements of leaflets and annulus in midesophageal long-axis view. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

8 Figure 7 Mitral leaflet anatomy as seen on 60–80° plane (also erroneously called bi-commissural plane). Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

9 Figure 8 Prolapsing P2 is seen in this view (60°).
Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

10 Figure 9 Leaflet anatomy in short axis transgastric plan.
Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

11 Figure 10 Schematic diagram of transesophageal echocardiography imaging planes shows normal coaptation of valve leaflets below the level of the mitral annulus. Left: four-chamber (0°) plane; right: long-axis (135°) plane. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

12 Figure 11 Schematic views showing mitral valve prolapse with chordae rupture with the posterior leaflet going above the annular plane (interrupted lines) in the four-chamber (left) and long-axis (right) views. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

13 Figure 12 Schematic views showing bileaflet billowing with mitral valve prolapse in which both leaflets prolapse above the annular plane (interrupted lines). Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

14 Figure 13 Flow acceleration of mitral regurgitation jets as seen on ventricular side of the mitral leaflets provide exact location of valve regurgitation. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

15 Figure 14 Real-time 3D image of the mitral valve anatomy as visualized en face from the left atrial view. Journal of Cardiology  , DOI: ( /j.jjcc ) Copyright © Terms and Conditions

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