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Mitral Regurgitation:

Assessing Mechanism and Severity

Enrique Garcia-Sayan, MD, FACC, FASE

Associate Professor, Baylor Colege of Medicine

(Houston, TX, USA)

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THEO NATIONAL CONGRESS O VIETNAMESE SOCIETY OFUTRASOUNDIN MEDICINE

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Mitral Valve: Complex Morphology

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Mitral Valve: Complex Morphology

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Carpentier Classification Type|

* Normal leaflet motion

* Primaroyr Secondary MR
* Annular dilatation (Atrial Functional MR}
* Leaflet Perforation

Leaflet Perforation ls Nonischemic
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ANNULAR DILATATION PERFORATION

Carpentier Classification Type

* Increased leaflet motion

* Classic Primary MR (DM)
* Ruptured chordae, prolap/slel

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Carpentier Classification Typlel

* Systolic + Diastolic leaflet restriction

* Commisural fusion
* Leaflet thickening
*Chordal fusion

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Carpentier Classification Type Ib

* Systolic leaflet restriction

* Cassi SeconMdRa(rFMyR)

* Apical tethering

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ASE'S Comprehensive Echocardiograpy, Second Edition

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TTE PLAX or 3-ch view

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Tips to Identitfhye Affected Scallop with 2D Echo

* chamorbloeng-raxis

* Anterior

* Posterior

* TEE bi-commissural

* Lateral)

* Cente2r)

* Medial (3)

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* Primary MR: Jet away from affected leaflet

* SecondarMRy: Jet towards affected leaflet

* Watch for pseudo-prolapse in secondary MR

Comprehensive TEE Assessment

Assessing Morphology and Mechanism:
Bi-Comiss+Buirplaanle at Multiple Levels or Sweep

Integrate 2D and 3D Evaluation

DetermMiRnSievenrigty: Qualitative Methods

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