THE MORPHOLOGIC CHARACTERISTICS OF FLAIL MITRAL LEAFLETS BY TRANSESOPHAGEAL ECHOCARDIOGRAPHY

Background and aims of the study: Mitral valve prolapse due to floppy mitral valve (MVP/FMV) is a common valvular abnormality with a variabl e clinical course. Flail mitral valve leaflet resulting in severe mitr al regurgitation is a complication of MVP/FMV. Methods: In order to un derstand the structural correlates of flail mitral valve leaflet in MV P, we reviewed the morphologic characteristics of the mitral valve by transesophageal echocardiography (TEE) in 72 patients (24 normal; 26 m itral valve prolapse; 22 flail mitral valve leaflet). Results: Compare d with the normal group, the mitral valve prolapse group had greater a nterior and posterior mitral valve leaflet thickness and anterior mitr al valve leaflet length. Patients with flail mitral valve leaflets as a complication of FMV had greater anterior and posterior mitral valve leaflet length and posterior mitral valve leaflet thickness compared w ith MVP patients without flail mitral valve leaflets. Posterior mitral valve leaflet length was the only echocardiographic independent predi ctor of flail mitral valve leaflet. Older FMV patients with increased mitral valve leaflet length and thickness are predisposed to flail mit ral valve leaflets and severe mitral regurgitation. Conclusions: TEE m ay identify patients with MVP/FMV with the greatest structural abnorma lities who are at risk for complications such as flail mitral valve le aflet(s).