Hostname: page-component-848d4c4894-75dct Total loading time: 0 Render date: 2024-06-01T20:15:07.046Z Has data issue: false hasContentIssue false
  • English
  • Français

Echocardiography of congenital mitral valve disorders: echocardiographic–morphological comparisons*

Published online by Cambridge University Press:  29 December 2014

Norman H. Silverman
Norman H. Silverman*
Affiliation:
Division of Pediatric Cardiology, Stanford University and University of California San Francisco, Palo Alto, California, United States of America
*
Correspondence to: N. H Silverman, MD, DSc (Med), Division of Pediatric Cardiology, Stanford University and University of California San Francisco, 750 Welch Road – Suite 305, Mail code 5731, Palo Alto, California 94304, United States of America. Tel: +650 723 7913; Fax: +650 497 8422; Email: norm.silverman@stanford.edu
Get access Rights & Permissions [Opens in a new window]

Abstract

I surveyed our echocardiographic database of the years between 1998 and 2012 for congenital abnormalities of the mitral valve in patients over 14 years. A total of 249 patients with mitral valve abnormalities were identified. Abnormalities included clefts in the mitral valve in 58 patients, double orifice of the mitral valve in 19, mitral stenosis with two papillary muscles in 72, and mitral stenosis with one papillary muscle in 51 patients. Supravalvar rings were found in 35 patients with a single papillary muscle, and mitral stenoses with two papillary muscles were found in 22 patients. Mitral prolapse occurred in 44 patients and mitral valvar straddle in five patients. The patients were evaluated by all modalities of ultrasound available over the course of time. Although some lesions were isolated, there were many lesions in which more than one mitral deformity presented in the same patient. The patients are presented showing anatomical correlation with autopsy specimens, some of which came from the patients in this series, and others matched to show correlative anatomy. These lesions remain rare as a group and continue to have high morbidity and mortality.

Keywords

Congenital mitral stenosisdouble orifice cleft mitral valvessupravalvar mitral ringstraddling mitral valvemitral prolapse
Type
Original Article
Information
Cardiology in the Young , Volume 24 , Issue 6: HeartWeek 2014 , December 2014 , pp. 1030 - 1048
Copyright
© Cambridge University Press 2014 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

*

Presented at All Children)s Hospital Johns Hopkins Medicine 14th International Symposium on Congenital Heart Disease, Saint Petersburg, Florida, United States of America, 15–18 February 2014, Special Focus: Diseases of the Cardiac Valves from the Fetus to the Adult, Co-Sponsor: The American Association for Thoracic Surgery (AATS).

References

1.Banerjee, A, Kohl, T, Silverman, NH. Echocardiographic evaluation of congenital mitral valve anomalies in children. Am J Cardiol 1995; 76: 1284–1291.Google Scholar
2.Smallhorn, JF. Echocardiographic Assessment of Mitral Valve Abnormalities. In: Eidem, BW, Cetta, F, O’Leary, PW. (eds). Echocardiography in Pediatric and Adult Congenital Disease Chapter 9 Woltes Kluwer/Lippincott Williams Wilkins, Philadelphia, 2010; Chapter 9, pp.131--144.Google Scholar
3.Mackie, AS, Smallhorn, JF. Anatomical and functional mitral valve abnormalities in the pediatric population. In: Allen, HD, Driscoll, DJ, Shaddy, RE, Feltes, TF. (eds). Moss and Adam’s Heart Disease in Infants, Children and Young Adult Chapter 45 Woltes Kluwer/Lippincott Williams Wilkins, Philadelphia, 2010.Google Scholar
4.Smallhorn, JF. Anomalies of the morphologically abnormal mitral valve. In: Anderson, RH, Baker, EJ, Penny, DJ, Reddington, AN, Rigby, ML, Wernovsky, G. (eds). Pediatric Cardiology. Chruchill Livingstone/Elsevier, Philadelphia, 2010; Chapter 35; pp. 731-- 751.CrossRefGoogle Scholar
5.Séguéla, P-E, Houyel, L, Acar, P. Congenital malformations of the mitral valve. Arch Cardiovasc Dis 2011; 104: 465–479.Google Scholar
6.Kohl, T, Silverman, NH. Comparison of cleft and papillary muscle position in cleft mitral valve and atrioventricular septal defect. Am J Cardiol 1996; 77: 164–169.Google Scholar
7.Sigfusson, G, Ettedgui, JA, Silverman, NH, Anderson, RH. Is a cleft in the anterior leaflet of an otherwise normal mitral valve an atrioventricular canal malformation? J Am Coll Cardiol 1995; 26: 508–515.CrossRefGoogle ScholarPubMed
8.Punn, R, Silverman, NH. Echocardiography in patients with left ventricular inflow lesions. Pediatr Ultrasound Today 2008; 13: 3–23.Google Scholar
9.Biaggi, P, Greutmann, M, Crean, MD. Utility of three-dimensional transesophageal echocardiography: anatomy, mechanism, and severity of regurgitation in a patient with an isolated cleft posterior mitral valve. J Am Soc Echocardiogr 2010; 23: 1114.e1–1114.e4.Google Scholar
10.Seguela, P-E, Brosset, P, Acar, P. Isolated cleft of the posterior mitral valve leaflet assessed by real-time 3D echocardiograph. Arch Cardiovasc Dis 2011; 104: 365–366.Google Scholar
11.Bano-Rodrigo, A, Van Praagh, S, Trowitzsch, E, et al. Double orifice mitral valve: a study of 27 postmortem cases with developmental, diagnostic and surgicalconsiderations. Am J Cardiol 1988; 61: 152–160.Google Scholar
12.Di Segni, E, Lew, S, Shapira, H, Kaplinsky, E. Double mitral valve orifice. Pediatr Cardiol 1986: 215–217.CrossRefGoogle ScholarPubMed
13.Aggarwal, G, Schlosshan, D, Arronis, C, Mathur, G, Cranney, G. Real-time 3-dimensional transesophageal echocardiography evaluation of a patient with concomitant double-orifice mitral valve, bicuspid aortic valve, and coarctation of the aorta. Circulation 2009; 120: e277–e279.CrossRefGoogle ScholarPubMed
14.Garcıa-Blas, S, Salinas, P, Domınguez, FJ, Moreno, M, Lopez-Sendon, JL. Double orifice mitral valve. J Am Coll Cardiol 2013; 61: e414.Google Scholar
15.Trowitzsch, E, Bano-Rodrigo, A, Burger, BM, Colan, SD, Sanders, SP. Two-dimensional echocardiographic findings in double orifice mitral valve. J Am Coll Cardiol. 1988; 61: 152–160.Google Scholar
16.Bano-Rodrigo, A, Van Praagh, S, Trowitzsch, E, Van Praagh, R. Double orifice mitral valve: a study of 27 postmortem cases with developmental, diagnostic and surgical considerations. Am J Cardiol 1988; 61: 152–160.Google Scholar
17.Collins-Nakai, RL, Rosenthal, A, Castaneda, AR, et al. Congenital mitral stenosis: a review of 20 years experience. Circulation 1977; 56: 1039–1047.Google Scholar
18.Ruckman, RN, Van Praagh, R. Anatomic types of congenital mitral stenosis: report of 49 autopsy cases with consideration of diagnosis and surgical implications. Am J Cardiol 1978; 42: 592–601.CrossRefGoogle ScholarPubMed
19.Moore, P, Adatia, I, Spevak, PJ, et al. Severe congenital mitral stenosis in infants. Circulation 1994; 89: 2099–2106.Google Scholar
20.Edwards, JE, Layman, TE. Anomalous mitral arcade: a type of congenital mitral insufficiency. Circulaton 1967; 35: 389–395.Google Scholar
21.Shone, JD, Sellers, RD, Anderson, RC, Adams, P, Lillehei, CW, Edwards, JE. The developmental complex of parachute mitral valve, supravalvular ring of left atrium, subaortic stenosis and coarctation of the aorta. Am J Cardiol 1963; 11: 714–725.Google Scholar