Anomalies of Left Ventricular Inflow and Mitral Valve

Abstract

Obstruction of left ventricular inflow includes pulmonary vein stenosis, cor triatriatum and supravalvular and valvular mitral stenosis. Morphologic diagnosis of these anomalies is greatly enhanced by colour Doppler examination. PW and CW Doppler in pulmonary vein stenosis and in cor triatriatum reveal a continuous systolic-diastolic flow profile. Documentation of flow velocities in patients with significant supravalvular mitral ring stenosis and mitral valvular stenosis requires application of CW Doppler. Description of severity of mitral valve stenosis to a large extent relies on determination of the mean gradient. PW and CW Doppler evaluations of possible pulmonary and tricuspid regurgitation are important tools in the detection of secondary pulmonary hypertension. Congenital mitral regurgitation is encountered in patients with mitral valve prolapse, mitral valve cleft or dysplastic mitral valve. Functional mitral regurgitation is found in children with dilated cardiomyopathy, myocarditis or ischaemic alterations of the papillary muscles and in patients with severe aortic stenosis or anomalous origin of coronary arteries from the pulmonary artery. Colour Doppler helps to visualize the origin and size of the regurgitant jet. However assessment of the severity of mitral regurgitation requires the inclusion of clinical data, 2D echo and PW and CW Doppler.