Andersons pediatric cardiology 1461
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FIG.55.4 Schematicimagesofthemitralvalve.(A)Systolicframeina
normalpatientshowingacompetentmitralvalveintheclosedposition.
Notetheextentofcoaptationofthetwoleaflets.(B)Diastolicframe
showingawideopenmitralvalve.(C)Systolicframeinregurgitantheart
disease.Theanteriormitralvalveleaflet(AMVL)isshortenedand
thickenedasaresultoffibrosis.Theposteriormitralvalveleaflet(PMVL)is
relativelyfixed.ThetipoftheAMVLfacestheleftatrium.Theleafletsdo
notcoapt.(D)Diastolicframeshowingrestrictionofthemitralvalveorifice
becauseofrestrictedmobilityofbothAMVLandPMVL.Notethe“dogleg”
deformityoftheAMVL.
FIG.55.5 EchocardiographicequivalentsofFig.55-4.Echocardiograms
fromanormalpatientduringsystole(A)anddiastole(B).(C–D)
Echocardiogramsobtainedfromapatientwithrheumaticheartdiseaseand
mitralvalvedisease.(C)Systolicframedemonstratingthickeningofthe
anteriormitralvalveleaflet(AMVL)tipandafixedposteriormitralvalve
leaflet(PMVL).ThetipoftheAMVLdoesnotcoaptwiththePMVL,
resultinginavisiblegap.Themitralregurgitationoccursthroughthisgap
andisdirectedtowardtheposteriorandlateralwalloftheleftatrium.
