Author + information
- Received January 10, 1986
- Revision received May 28, 1986
- Accepted June 13, 1986
- Published online November 1, 1986.
- Kunio Miyatake, MD*,1,
- Katsuhiro Yamamoto, MD*,
- Yung-Dae Park, MD*,
- Shiro Izumi, MD†,
- Masakazu Yamagishi, MD*,
- Hiroshi Sakakibara, MD* and
- Yasuharu Nimura, MD, MSc†
- ↵1Address for reprints: Kunio Miyatake, MD, Cardiology Division of Medicine, National Cardiovascular Center, 7-1, Fujishiro-dai 5-chome, Suita, Osaka 565 Japan.
It has been difficult to diagnose mitral regurgitation due to valve perforation using either noninvasive or invasive methods, differentiating it from that resulting from incomplete coaptation of the mitral valve. This report describes three patients with infective endocarditis and mitral valve perforation, which was definitively diagnosed by the real-time two-dimensional Doppler flow imaging technique.
In these three patients, B-mode echocardiography demonstrated an echo interruption on the anterior mitral leaflet. However, it was not certain whether this interruption was simply an echo dropout or indicated an interruption of the valve tissue. Doppler flow imaging then demonstrated unusual flow in the vicinity of the echo interruption, which appeared to flow from the left ventricular cavity into the left atrial cavity across the midportion of the anterior mitral valve leaflet during systole and in the opposite direction during diastole. This was interpreted as mitral valve perforation. In general, Doppler flow imaging may play a complementary role with B-mode echocardiography in cardiac diagnosis.
- Received January 10, 1986.
- Revision received May 28, 1986.
- Accepted June 13, 1986.
- American College of Cardiology Foundation