Echocardiographic Diagnosis of Mitral Apparatus Dysfunction with Mitral Insufficiency

Abstract

The normal continuity between the posterior aortic root echo and the anterior mitral leaflet can be demonstrated by a sweep of the ultrasound beam from the aorta down through the mitral valve. The significance of abnormal systolic closure of the anterior mitral leaflet behind the aortic root was examined prospectively in 92 patients (pts) undergoing cardiac catheterization. Of 4 9 pts with mitral closure 8 mm posterior to the aortic root, 46 had no mitral insufficiency (MI) by cineangiography. Two of the remaining 3 had echo and angiographic evidence of posterior leaflet prolapse. Of the 43 pts with mitral closure 8 mm behind the aortic root, 41 (95%) had MI. No correlation was found between the degree of abnormal closure and the severity of MI. The etiology of the MI varied and included coronary artery disease (29%), congenital heart disease (21%), cardiomyopathy (15%) and rheumatic heart disease (12%). Pts with mitral stenosis were excluded from this study.