Two-dimensional echocardiographic findings in double orifice mitral valve

Abstract

Between December 1981 and April 1984, five children ranging in age from 1 month to 5 1/2 years examined by two-dimensional echocardiography appeared to have a double orifice mitral valve. The diagnosis was verified in one patient at surgery, one patient by angiography and one patient by necropsy. Associated malformations included mitral stenosis and regurgitation, coarctation of the aorta, ostium primum and secundum atrial septal defect, ventricular septal defect and hypoplastic left heart syndrome. Three varieties of double orifice mitral valve were observed: an incomplete bridge type (one patient), in which a small strand of tissue connected the anterior and posterior leaflets at the leaflet edge level; a complete bridge type (three patients), in which a fibrous bridge divided the atrioventricular orifice completely into equal or unequal parts and a hole type (one patient), in which an additional orifice with subvalvular apparatus occurred in the posterior commissure of the mitral valve. These three types could be distinguished by sweeping the transducer in cross-sectional view from the apex toward the base of the heart. Both orifices could be seen throughout the scan in the complete bridge type while in the incomplete bridge type the two orifices could be seen only at the level of the papillary muscles. In the hole type, the second orifice was seen at about midleaflet level. In all three types, the chordae surrounding each orifice attached to only one papillary muscle. Congenital mitral stenosis or regurgitation was evident in three patients. The type of the double orifice mitral valve did not predict the presence or severity of symptoms.

Congenital Double-Orifice Mitral Valve with Mitral Valve Prolapse and Severe Mitral Regurgitation

“…5) Complete bridging type as our case is reportedly most common, where 2 distinct orifices are seen in all levels of mitral valve leaflets.…”

Congenital Double-Orifice Mitral Valve in Asymptomatic Patients

“…6) The clinic manifestation and management not only depend on the severity of mitral valve dysfunction, but also on the associated malformations. 7) Both of our cases were complete bridge type, with a fibrous bridge dividing the left atrioventricular orifice into approximately equal parts, as demonstrated by 3D TTE.…”

Well‐functioning double‐orifice mitral valve in a young adult

“…Transthoracic echocardiography is a valuable tool for the diagnosis of DOMV, but the lesion may be missed when imaging is suboptimal. 3 The multiplane transesophageal approach offers additional information that is useful for recognizing DOMV, evaluating its anatomic characteristics and functional status, and identifying coexisting malformations.…”