Carpentier classification of mitral valve regurgitation

Last revised by Yuranga Weerakkody on 12 Jun 2019

The Carpentier classification divides mitral valve regurgitation into three types based on leaflet motion 1:

  • type I: normal leaflet motion
    • annular dilation, leaflet perforation
    • regurgitation jet directed centrally
  • type II: excessive leaflet motion
    • papillary muscle rupture, chordal rupture, redundant chordae
    • eccentric jet, directed away from involved leaflet
  • type III: restricted leaflet motion
    • IIIa: leaflet motion restricted in both systole and diastole
    • IIIb: leaflet motion restricted in diastole
      • papillary muscle dysfunction, left ventricular dilation
      • jet may be centrally or eccentrically directed

Radiographic features

Using transthoracic echocardiography, the mitral valve may be interrogated for regurgitation with color flow Doppler, with an optimal Nyquist aliasing velocity set between 50-60 cm/s 2.

  • type I
    • regurgitation jet directed centrally, coaptation defect 
  • type II
    • disproportionate excursion of one leaflet, with a regurgitant jet eccentrically directed away from the involved leaflet
  • type III
    • decreased excursion of one or both leaflets
    • regurgitant jet will be directed away from the involved leaflet if the other is spared, and centrally directed if both leaflets involved
      • IIIa
        • aberrant systolic excursion and diastolic coaptation 
      • IIIb
        • leaflet restriction limited to diastole 3

ADVERTISEMENT: Supporters see fewer/no ads

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.