Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access
Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc
Journal website http://www.jocmr.org

Original Article

Volume 8, Number 12, December 2016, pages 893-898

Bi-Luminal Mitral Valve: Incidence, Clinical Features, Associated Anomaly and Echocardiographic Evaluation

Figures

Figure 1.
Figure 1. Complete bridge type of DOMV: apical four-chamber view showing TR (A); TEE showing mitral regurgitation, parasternal (B); short-axis (PSAX) view showing severe mitral stenosis by pressure half time (C) and planimetry (D).
Figure 2.
Figure 2. DOMV with ventricular septal defect with left-to-right shunt (A, B) and complete endocardial cushion defect (C, D).
Figure 3.
Figure 3. TTE basal short-axis view showing patent ductus arteriosus (A, B). Incomplete bridge type of DOMV on 2D (C) and 3D transthoracic echo (D).

Tables

Table 1. Baseline Characteristics and Clinical Presentation of Patients (n = 28)
 
VariablesNo. (%)
CVS: cardiovascular system; ECG: electrocardiogram; LAD: left axis deviation; NYHA: New York Heart Association.
Age (mean ± SD)20.1 ± 4.9
Gender (male/female)10/18 (1:1.8)
Clinical presentation
  Dyspnea19 (67.8)
  Palpitation6 (21.4)
  Fatigue4 (14.2)
  Hemoptysis2 (7.1)
  Embolic phenomenon2 (7.1)
NYHA functional class
  I7 (25)
  II17 (60.7)
  III4 (14.3)
  IV-
CVS examination
  Diastolic thrill4 (14.3)
  Systolic thrill4 (14.3)
  Continuous thrill3 (10.7)
  Diastolic murmur19 (67.8)
  Pansystolic murmur12 (42.8)
  Continuous murmur3 (10.7)
ECG
  Normal sinus rhythm25 (89)
  Atrial flutter/fibrillation3 (10.7)
  LAD3 (10)

 

Table 2. Details of Echocardiographic Evaluation of Patients With DOMV (n = 28)
 
Type of DOMVMitral stenosisAssociated lesionsN (%)
SeverityMVA (cm2)Gradient (mean mm Hg)
DOMV: double orifice mitral valve; MVA: mitral valve area; TR: tricuspid regurgitation; VSD: ventricular septal defect; MR: mitral regurgitation; ECD: endocardial cushion defect; ASD: atrial septal defect; PDA: patent ductus arteriosus; Vmax: maximum peak velocity; PGmax: maximum peak gradient.
Complete bridge type (89%)Severe0.4 - 0.814 - 28Severe TR13 (46)
VSD3 (11)
Mild to moderate MR2 (7)
ECD (complete) - primum ASD and VSD3 (11)
Moderate1.5 - 1.75 - 8Moderate MR4 (14)
Incomplete bridge type (11%)Severe0.9 - 117 - 32PDA (Vmax/PGmax) = 5.4/1203 (11)