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Case Studies: Primary Mitral Regurgitation

Case 1

A 41yo patient complained of dyspnea and decreased exercise tolerance. After consultation with a cardiologist they were referred to our laboratory for comprehensive echocardiogram. Two dimensional (2D) and three dimensional (3D) transthoracic echocardiogram (TTE) was performed. Video 1-1 shows the long axis parasternal view. Video 1-2 shows a 3-chamber apical view. Figure 1-3 shows vena contracta (VC) measurement. Figure 1-4 shows proximal isovelocity surface area radius (PISA). Video 1-5 shows 3D left ventricular volume and ejection fraction evaluation. Figure 1-6 shows mitral valve inflow velocity time integral (MV VTI) and left ventricle outflow tract VTI (LVOT VTI).

Echo findings were the following: prolapsing mitral valve leaflets, coaptation defect, regurgitation jet with VC 0,66 cm, PISA radius - 1,64 cm, effective regurgitant orifice area (EROA) measured through PISA and VTI- 0,8 cm2, MV VTI\LVOT VTI- 1,76, regurgitation fraction- 73%, left ventricle ejection fraction (LV EF)- 71%, LV end-diastolic volume -190 ml, LV end-systolic diameter- 42 mm.


Video 1-1


Video 1-2


Figure 1-3

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Figure 1-4


Video 1-5


Figure 1-6



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