Abstract:SUMMARY A 64 year old woman with partial atrioventricular canal and double orifice mitral valve presented with severe mitral regurgitation secondary to a torn leaflet. The double orifice regurgitant mitral valve is an unusual finding at operation. Double orifice mitral valve is an unusual congenital abnormality that is rarely of clinical importance. We describe a patient in whom this finding was associated with severe mitral regurgitation.Case report A 64 year old woman was noted to have a murmur at age 20, bu… Show more
“…Figure 1Three-dimensional transthoracic echocardiographic images of the mitral valve from the left ventricle (above) and left atrial ‘surgeon’s view’ (below). Evidence of two asymmetrical inlet orifices, a bigger anterolateral (1) and a smaller posteromedial (2) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening.
TTE 3D zoom mode acquisition of a double orifice mitral valve, imaged from left atrial surface (‘surgeon’s view’). View Video 1 at http://movie-usa.glencoesoftware.com/video/10.1530/ERP-17-0023/video-1.…”
Section: Investigationmentioning
confidence: 99%
“…Evidence of two asymmetrical inlet orifices, a bigger anterolateral (1) and a smaller posteromedial (2) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening.…”
Section: Investigationmentioning
confidence: 99%
“… Three-dimensional transthoracic echocardiographic images of the mitral valve from the left ventricle (above) and left atrial ‘surgeon’s view’ (below). Evidence of two asymmetrical inlet orifices, a bigger anterolateral ( 1 ) and a smaller posteromedial ( 2 ) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening. …”
Section: Investigationmentioning
confidence: 99%
“…Due to its common association with other congenital heart defects, DOMV is usually discovered in childhood or early adolescence ( 1 ). This case highlights the possibility of detecting congenital mitral valve anomalies, not only in the younger population, but also as an incidental finding in elderly patients referred for other indications.…”
A rare isolated double orifice mitral valve (DOMV) was diagnosed in a 77-year-old male patient, being assessed for surgical repair of the ascending aorta. This is a rare congenital abnormality, usually discovered as an incidental finding during investigation of other congenital heart defects. This case shows that a detailed assessment of all cardiac structures is necessary, not only in young patients, but also in the elderly population, to minimise the under-diagnosis of such rare anomalies. The use of 3D transthoracic echocardiography (TTE) has an increasingly significant role in establishing the diagnosis and extending the morphological and functional understanding of the anomaly.Learning points:Thoroughly assessing all cardiac structures, in accordance with the minimum dataset guidelines for transthoracic echocardiography, ensures not only a comprehensive assessment of the primary indication for the scan, but also improves the detection of concomitant and otherwise unknown lesions.
Despite falling under the category of congenital heart defects, several rare anomalies such as DOMV can be present in elderly patients, and the adult echocardiographer should have appropriate knowledge and awareness for detecting these conditions.
3D TTE provides a comprehensive assessment of the morphology of DOMV, over and above the information obtained by 2D imaging.
“…Figure 1Three-dimensional transthoracic echocardiographic images of the mitral valve from the left ventricle (above) and left atrial ‘surgeon’s view’ (below). Evidence of two asymmetrical inlet orifices, a bigger anterolateral (1) and a smaller posteromedial (2) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening.
TTE 3D zoom mode acquisition of a double orifice mitral valve, imaged from left atrial surface (‘surgeon’s view’). View Video 1 at http://movie-usa.glencoesoftware.com/video/10.1530/ERP-17-0023/video-1.…”
Section: Investigationmentioning
confidence: 99%
“…Evidence of two asymmetrical inlet orifices, a bigger anterolateral (1) and a smaller posteromedial (2) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening.…”
Section: Investigationmentioning
confidence: 99%
“… Three-dimensional transthoracic echocardiographic images of the mitral valve from the left ventricle (above) and left atrial ‘surgeon’s view’ (below). Evidence of two asymmetrical inlet orifices, a bigger anterolateral ( 1 ) and a smaller posteromedial ( 2 ) mitral orifices, separated by a central bridge of fibrous tissue (arrow), and with unrestricted opening. …”
Section: Investigationmentioning
confidence: 99%
“…Due to its common association with other congenital heart defects, DOMV is usually discovered in childhood or early adolescence ( 1 ). This case highlights the possibility of detecting congenital mitral valve anomalies, not only in the younger population, but also as an incidental finding in elderly patients referred for other indications.…”
A rare isolated double orifice mitral valve (DOMV) was diagnosed in a 77-year-old male patient, being assessed for surgical repair of the ascending aorta. This is a rare congenital abnormality, usually discovered as an incidental finding during investigation of other congenital heart defects. This case shows that a detailed assessment of all cardiac structures is necessary, not only in young patients, but also in the elderly population, to minimise the under-diagnosis of such rare anomalies. The use of 3D transthoracic echocardiography (TTE) has an increasingly significant role in establishing the diagnosis and extending the morphological and functional understanding of the anomaly.Learning points:Thoroughly assessing all cardiac structures, in accordance with the minimum dataset guidelines for transthoracic echocardiography, ensures not only a comprehensive assessment of the primary indication for the scan, but also improves the detection of concomitant and otherwise unknown lesions.
Despite falling under the category of congenital heart defects, several rare anomalies such as DOMV can be present in elderly patients, and the adult echocardiographer should have appropriate knowledge and awareness for detecting these conditions.
3D TTE provides a comprehensive assessment of the morphology of DOMV, over and above the information obtained by 2D imaging.
“…Double-orifice mitral valve (DOMV) is a rare congenital anomaly that was first described by Greenfield in 1876. [ 1 ] It can be seen in young and middle-aged patients, with an estimated incidence of 0.06%. [ 2 ] This anomaly is consisting of an accessory bridge of fibrous tissue, which partially or completely divides the mitral valve (MV) into two orifices.…”
Double-orifice mitral valve (DOMV) is a rare congenital anomaly consisting of an accessory bridge of fibrous tissue, which divides the mitral valve (MV) into two orifices. The mitral leaflets are essentially normal in most cases, but they can be regurgitant or stenotic. It is most commonly associated with a variety of other cardiac anomalies. Isolated DOMV with normal MV function is very rare. We present here a rare case of congenital DOMV in a 25-year-old female diagnosed by real-time three-dimensional echocardiography (RT3DE). RT3DE enabled complete anatomical and functional assessment of MV apparatus. It added much valuable information over conventional 2DE that helped in establishment of the diagnosis, identification of the anatomical type, and selection of the proper management.
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