Mitral valve prolapse
Mitral valve prolapse (MVP) is often defined as systolic bowing of the mitral leaflet more than 2 mm beyond the annular plane into the atrium 1. It is a common cause of mitral regurgitation (considered most frequent cause of severe non-ischemic mitral regurgitation 2).
It may affect up to 2-3% of the general population 3.
Mitral leaflet bowing is caused by rupture or elongation of the chordae tendineae (often due to myxomatous degeneration). The middle scallop of the posterior leaflet (P2 segment) is most often affected.
The most common phenotype of mitral prolapse is considered to be diffuse myxomatous degeneration of the mitral valve (Barlow disease - mitral valve)
Ultrasound / echocardiography
In mitral valve prolapse, the coaptation line lies behind the annular plane. On 2D echo, the diagnosis of a prolapse should be made in the parasternal or eventually the apical long-axis view and not on an apical four-chamber view, as the saddle shaped annulus could lead to a false positive diagnosis 5.
Treatment and prognosis
It is usually repaired surgically.
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- 2. Koo HJ, Yang DH, Oh SY et-al. Demonstration of mitral valve prolapse with CT for planning of mitral valve repair. Radiographics. 2014;34 (6): 1537-52. doi:10.1148/rg.346130146 - Pubmed citation
- 3. Han Y, Peters DC, Salton CJ et-al. Cardiovascular magnetic resonance characterization of mitral valve prolapse. JACC Cardiovasc Imaging. 2008;1 (3): 294-303. doi:10.1016/j.jcmg.2008.01.013 - Pubmed citation
- 4. Chen JJ, Manning MA, Frazier AA et-al. CT angiography of the cardiac valves: normal, diseased, and postoperative appearances. Radiographics. 2009;29 (5): 1393-412. Radiographics (full text) - doi:10.1148/rg.295095002 - Pubmed citation
- 5. Lancellotti, Patrizio, Moura, Luis, Pierard, Luc A., Agricola, Eustachio, Popescu, Bogdan A., Tribouilloy, Christophe, Hagendorff, Andreas, Monin, Jean-Luc, Badano, Luigi, Zamorano, Jose L., Sicari, Rosa, Vahanian, Alec, Roelandt, Jos R.T.C.. European Association of Echocardiography recommendations for the assessment of valvular regurgitation. Part 2: mitral and tricuspid regurgitation (native valve disease). (2010) European Journal of Echocardiography. 11 (4): 307. doi:10.1093/ejechocard/jeq031