J Cardiovasc Ultrasound.  2008 Sep;16(3):87-89. 10.4250/jcu.2008.16.3.87.

Congenital Double-Orifice Mitral Valve with Mitral Valve Prolapse and Severe Mitral Regurgitation

  • 1Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jmsong@amc.seoul.kr


A 27 year-old female presented with dyspnea on exertion, and was diagnosed using transthoracic and transesophageal echocardiography as congenital double-orifice mitral valve and mitral valve prolapse resulting in severe mitral regurgitation. This finding was confirmed by open heart surgery, and her mitral valve was successfully repaired with lateral commissural repair and ring annuloplasty using da Vinci system. We report this case with review of literature.


Double-orifice mitral valve; Mitral valve prolapse; Mitral regurgitation

MeSH Terms

Echocardiography, Transesophageal
Mitral Valve
Mitral Valve Insufficiency
Mitral Valve Prolapse
Thoracic Surgery


  • Fig. 1 Transthoracic echocardiography shows that (A) mitral valve is divided into 2 separate valve orifices (anterolateral & posteromedial, arrows) by a fibrous bridge on the parasternal short axis view, and (B) center part of anterior mitral leaflet (arrow), fibrous bridge does not move toward apex at diastole while the medial and lateral parts do on the apical 2-chamber view.

  • Fig. 2 Transesophageal echocardiography shows that (A) center part of anterior mitral leaflet (arrow), fibrous bridge not moving toward apex during diastole and (B) the prolapsed lateral scallop of the posterior mitral valve leaflet (P1 segment, arrow) into the left atrium during systole. The color Doppler image shows (C) 2 separate mitral inflows through 2 separate orifices, and (D) severe eccentric mitral regurgitation jet toward medial side of the left atrium.

  • Fig. 3 Intraoperative view of the mitral valve from the left atrial side shows 2 different mitral orifices (arrows) with equal size and central fibrous bridge. Arrowhead indicates prolapsed segment.


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