Parachute Mitral Valve in Adults—A Systematic Overview

Hakim, Fayaz A.; Kendall, Christopher; Alharthi, Mohsen; Mancina, Joel; Tajik, Jamil; Mookadam, Farouk

doi:10.1111/j.1540-8175.2009.01143.x

Cited by 56 publications

(67 citation statements)

References 15 publications

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“…Normal MV papillary muscles are located at the midsegment of the left ventricular wall and maintain an opposed position at a certain distance [5]. The MV bicuspid device consists of a valve ring, a valve leaflet, and the chordae tendineae together with papillary muscle [6].…”

Section: Discussionmentioning

confidence: 99%

Parachute mitral valve accompanied by bicuspid aortic valve on three‐dimensional transesophageal echocardiography

Feng

et al. 2012

The Kaohsiung J of Med Scie

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We report the findings of three‐dimensional (3D) transesophageal echocardiography (TEE) in a patient with a parachute mitral valve (MV) accompanied by aortic valve (AV) malformation. The results indicated an enhanced echo in MV anterior leaves, incrassate, and shortened subvalvular chordae tendineae, and posteromedial papillary muscle that had echo reinforcement, calcification, retroposition, and a significant decrease compared with anterolateral papillary muscle. In addition, the anterolateral papillary muscle was huge, with the bilateral papillary muscles fused partly, and the posterior subvalvular chordae tendineae incrassate, shortened, and attached parachute‐like to the anterolateral papillary muscle. The MV appeared dome‐shaped for the open limit in diastole with an MV area of 1.6 cm. Moreover, the left ventricle increased in size and the bicuspid AV was malformed. Continuous wave Doppler angiograph showed that the flow rate increased to 398 cm/seconds at the AV orifice area. A 3D form of the MV structure was observed from the left ventricle using 3D‐TEE inspection. The anterolateral papillary muscle was fused with its posteromedial homologue. The chordae tendineae was attached to the anterolateral papillary with the parachute‐like structure, indicating dome movement.

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Section: Discussionmentioning

confidence: 99%

Parachute mitral valve accompanied by bicuspid aortic valve on three‐dimensional transesophageal echocardiography

Feng

et al. 2012

The Kaohsiung J of Med Scie

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“…3 The diagnosis of these components can be made on TTE, but TEE has been shown to have an incremental value in the diagnosis of parachute mitral valve, 4 especially in older children and adults. TEE is also useful in demonstrating other associated lesions like atrial septal defects and atrial thrombi 5 in patients taken up for repair.…”

Section: Discussionmentioning

confidence: 99%

Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease

Rana¹,

Kumar²,

J³

2014

Journal of Perioperative Echocardiography

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Complex congenital heart diseases (CHD) often present as multiple cardiac lesions. The presence of one anomaly should stimulate the physician to perform a comprehensive assessment and look for other associated anomalies.1 Multimodal imaging may be necessary to diagnose such associated lesions as single imaging may occasionally miss them. Transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) are complimentary to each other. Routine use of TEE during intraoperative period may help us to refine diagnosis, detect the missing components and guide effective surgical repair. We present one such case where diagnosis and management were optimized by multimodal imaging.

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“…PMVs have unifocal attachment of the chordae tendineae on a single papillary muscle, whereas two separate papillary muscles with a severely unequal distribution of the chordae tendineae are involved in PLAMVs [1, 3]. The chordae tendineae in PMVs and PLAMVs are often underdeveloped and deteriorate the mobility of the mitral valve (MV) leaflets due to the markedly reduced interchordal spaces [4]. This anomaly of the papillary muscle location and the chordal distribution is often accompanied by reduced size of the mitral orifice during the diastolic phase, leading to obstruction of the inflow of blood from the left atrium to the left ventricle and affecting MV function.…”

Section: Introductionmentioning

confidence: 99%

“…This anomaly of the papillary muscle location and the chordal distribution is often accompanied by reduced size of the mitral orifice during the diastolic phase, leading to obstruction of the inflow of blood from the left atrium to the left ventricle and affecting MV function. When the chordae tendineae are excessively elongated in PMVs or PLAMVs, mitral regurgitation often occurs due to incomplete leaflet coaptation [4]. …”

Section: Introductionmentioning

confidence: 99%

Effect of Congenital Anomalies of the Papillary Muscles on Mitral Valve Function

2015

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Parachute mitral valves (PMVs) and parachute-like asymmetric mitral valves (PLAMVs) are associated with congenital anomalies of the papillary muscles. Current imaging modalities cannot provide detailed biomechanical information. This study describes computational evaluation techniques based on three-dimensional (3D) echocardiographic data to determine the biomechanical and physiologic characteristics of PMVs and PLAMVs. The closing and opening mechanics of a normal mitral valve (MV), two types of PLAMV with different degrees of asymmetry, and a true PMV were investigated. MV geometric data in a patient with a normal MV was acquired from 3D echocardiography. The pathologic MVs were modeled by altering the configuration of the papillary muscles in the normal MV model. Dynamic finite element simulations of the normal MV, PLAMVs, and true PMV were performed. There was a strong correlation between the reduction of mitral orifice size and the degree of asymmetry of the papillary muscle location. The PLAMVs demonstrated decreased leaflet coaptation and tenting height. The true PMV revealed severely wrinkled leaflet deformation and narrowed interchordal spaces, leading to uneven leaflet coaptation. There were considerable decreases in leaflet coaptation and abnormal leaflet deformation corresponding to the anomalous location of the papillary muscle tips. This computational MV evaluation strategy provides a powerful tool to better understand biomechanical and pathophysiologic MV abnormalities.

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Parachute Mitral Valve in Adults—A Systematic Overview

Cited by 56 publications

References 15 publications

Parachute mitral valve accompanied by bicuspid aortic valve on three‐dimensional transesophageal echocardiography

Parachute mitral valve accompanied by bicuspid aortic valve on three‐dimensional transesophageal echocardiography

Role of TEE in Improving Diagnostic Accuracy of Congenital Heart Disease

Effect of Congenital Anomalies of the Papillary Muscles on Mitral Valve Function

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