Department of Cardiology, Faculty of Medicine, Alexandria University, Alexandria, Egypt.
Echocardiography. 2022 Feb;39(2):404-406. doi: 10.1111/echo.15273. Epub 2022 Jan 11.
A 65-year-old female patient diagnosed with degenerative aortic valve disease and severe regurgitation on transthoracic echocardiography (TTE) also had severe mitral regurgitation (MR), but the exact mechanism of MR could not be determined. Transesophageal echocardiography (TEE) showed limited leaflet coaptation and a severe central MR jet. Further three-dimensional (3D) imaging revealed an indentation in the middle of P2 scallop almost reaching the annulus. This was consistent with the diagnosis of cleft posterior mitral valve leaflet. Unlike cleft anterior leaflet which can be clear on TTE short-axis images, cleft posterior leaflet may only be visible using 3D TEE. The identification of cleft posterior leaflet is essential in guiding surgical valve repair.
一位 65 岁女性患者，经胸超声心动图（TTE）诊断为退行性主动脉瓣疾病和重度反流，同时也有严重的二尖瓣反流（MR），但无法确定 MR 的具体机制。经食管超声心动图（TEE）显示瓣叶有限的对合和严重的中心型 MR 射流。进一步的三维（3D）成像显示 P2 瓣叶中部有一个凹陷，几乎到达瓣环。这与后瓣裂的诊断一致。不同于前瓣裂，前瓣裂在 TTE 短轴图像上可以清晰显示，而后瓣裂可能仅在 3D TEE 上可见。识别后瓣裂对于指导外科瓣修复至关重要。
