Ahmed A. Arifi

Echocardiography of the mitral valve

Mitral valve disease is the second most common valvular heart disease after the aortic valve worldwide. Mitral valve has historically been a structure of interest by pioneers in echocardiography. One of the earliest applications of echocardiography was in the diagnosis of valvular heart disease, particularly mitral stenosis. In this review we wish to take the reader through the structural and hemodynamic evaluation of the normal mitral valve.

Echocardiographic atlas of the mitral regurgitation

Mitral regurgitation (MR) is defined as the loss of the smooth and adequate trimming closure of the mitral valve, which results in the reflux of blood from the left ventricle into the left atrium during systole. The functional competence of the mitral valve relies on the proper and coordinated interaction of the following structures: the mitral annulus, and leaflets, chordate tendineae, papillary muscles, left atrium and the left ventricles. This article will describe the echocardiography assessment of the mitral valve regurgitation with special emphasis on the trans-esophageal and 3D echocardiography. The echocardiography images were all original with special attention to the unique surgical view of the images.

Echocardiography in mitral stenosis.

Echocardiography plays a major role in diagnosis, etiology and severity of Mitral Stenosis (MS), analysis of valve anatomy and decision-making for intervention. This technique has also a crucial role to assess consequences of MS and follow up of patients after medical or surgical intervention. In this article we review the role of conventional echocardiography in assessment of mitral stenosis and future direction of this modality using 3D echocardiography.

Moderate ischemic mitral regurgitation: Is there a case for early intervention?

Ischemic mitral regurgitation (IMR) results from left ventricular remodelling after myocardial infarction and severely affects cardiovascular mortality and morbidity. Ischemic mitral valve regurgitation also represents a negative prognostic factor for long-term survival in patients undergoing surgical myocardial revascularization. While severe mitral regurgitation should always be corrected during a coronary artery bypass operation, the decision making is more difficult in patients with a moderate degree of regurgitation. In this review, we wish to highlight the negative impact of IMR on long-term survival and discuss the available evidence for surgical correction of IMR at the time of coronary revascularization.