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(Circulation. 1973;48:514.)
© 1973 American Heart Association, Inc.

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Angiographic-Morphologic Correlation in Patients with Severe Mitral Regurgitation Due to Prolapse of the Posterior Mitral Valve Leaflet

N. RANGANATHAN M.B.B.S.¹; M. D. SILVER M.D.¹; T. I. ROBINSON M.D.¹; W. J. KOSTUK M.D.¹; C. H. FELDERHOF M.D.¹; N. L. PATT M.D.¹; J. K. WILSON M.D.¹; E. D. WIGLE M.D.¹

¹ From the Departments of Medicine and Pathology, University of Toronto, St. Michael's and Toronto General Hospitals, Ontario, Canada.

Angiographic-morphologic correlation was done on findings in 16 patients with proven prolapse of the posterior mitral leaflet and severe mitral regurgitation. A triscalloped bulge into the left atrium in the left ventriculogram taken in the right anterior oblique projection is caused by prolapse of all three scallops of the posterior mitral leaflet. The prolapsed middle scallop produces a central bulge, the prolapsed posteromedial commissural scallop a posteroinferior bulge ih tne area of the posteromedial commissure, and the prolapsed anterolateral commissural scallop an anterosuperior bulge in the anterolateral commissural area. The latter is often overlapped by the aortic root but if prominent, juts beyond it. Correlation proved that the diagnosis of individual scallop prolapse in this syndrome can be made accurately despite gross mitral regurgitation.

Key Words: Mitral click syndrome • Ruptured chordae tendineae • Myxomatous degeneration of the mitral valve

Submitted on April 10, 1973
Accepted on May 21, 1973

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