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Figure 3b: (a) Oblique CT image through long axis of LV and LA in 66-year-old man shows incompetent mitral valve closure during systole (at 10% of the R-R interval); the leaflets create a regurgitant orifice (arrowheads). Note the thickened tendinous cords (arrows) and the thickened free margin of the anterior leaflet. Inset: Perpendicular reconstruction clearly shows the regurgitant orifice (arrowheads); planimetric measurements indicated that the ROA was 46 mm2. (b) TEE image in four-chamber view at 0° similarly shows the incomplete coaptation (arrowheads), thickened tendinous cords (arrows), and thickened leaflets. Inset: Color Doppler echocardiogram shows a jet (arrowheads) regurgitating into the LA; mitral regurgitation was considered moderate (grade 2) in this patient. (c) Ventriculogram obtained in 60° left anterior oblique projection shows contrast medium backflow (arrowheads) from the LV into the LA during systole; this mitral regurgitation was considered moderately severe (grade 3).
