Images in medicine
Double orifice mitral valve associated with bicuspid aortic valve
Válvula mitral de doble orificio asociada a válvula aórtica bicúspide
Consuelo Orihuela-Sandovala, Edgar García-Cruzb, José Miguel Torres-Martelb, Daniel Manzur-Sandovalc,
Corresponding author
drdanielmanzur@gmail.com
Corresponding author at: National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico.
Corresponding author at: National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico.
a Department of Echocardiography, National Institute of Medical Sciences and Nutrition Salvador Zubirán, Vasco de Quiroga 15, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico
b Adult Congenital Heart Disease Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico
c Cardiovascular Critical Care Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico
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Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico" "etiqueta" => "a" "identificador" => "af0005" ] 1 => array:3 [ "entidad" => "Adult Congenital Heart Disease Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico" "etiqueta" => "b" "identificador" => "af0010" ] 2 => array:3 [ "entidad" => "Cardiovascular Critical Care Unit, National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico" "etiqueta" => "c" "identificador" => "af0015" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cr0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author at: National Institute of Cardiology Ignacio Chávez, Juan Badiano 1, Belisario Domínguez - Sección XVI, Tlalpan, Mexico City, PO 14080, Mexico." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Válvula mitral de doble orificio asociada a válvula aórtica bicúspide" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1524 "Ancho" => 1423 "Tamanyo" => 224215 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram. A. Paraesternal short axis view at the great vessels in diastole. Bicuspid aortic valve with fusion of the right and left coronary cusps (white asterisk). B. Paraesternal short axis mitral view. Two separate mitral valve orifices were visualized; right (white arrow) and left orifice (red arrow). C. 3D transesophageal echocardiogram (multiplanar reconstruction); right (white arrow) and left orifice (red arrow). Two mitral orifices of equal size are shown. LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle, RVOT: right ventricular outflow tract. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="s0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0005">Case description</span><p id="p0005" class="elsevierStylePara elsevierViewall">An 18-year-old patient was referred to the adult congenital heart disease unit, with previous history of bicuspid aortic valve (BAV). Her physical examination was unremarkable. Transthoracic echocardiography (TTE) revealed a BAV with fusion of the right and left coronary cusps (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>A). On parasternal short-axis view, 2 separate mitral valve orifices were visualized (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>B). A three-dimensional transesophageal echocardiogram (3D TEE) was performed showing a complete double orifice mitral valve (DOMV): the mitral subvalvular apparatus was located between the anterior and posterior leaflets, and the mitral orifice was divided in 2 components by a fibrous bridge, with the 2 orifices of equal size (<a class="elsevierStyleCrossRef" href="#f0005">Fig. 1</a>C and Video 1).</p><elsevierMultimedia ident="f0005"></elsevierMultimedia><p id="p0010" class="elsevierStylePara elsevierViewall">DOMV is an extremely rare pathology, with an incidence of 0.05%, characterized by a 2-channel atrioventricular valve in the left ventricle that is typically asymptomatic. The most common associated lesions reported are BAV and coarctation of the aorta. It can present as mitral regurgitation or, less frequently, stenosis. Management is related to the type and severity of mitral valve dysfunction.</p><p id="p0015" class="elsevierStylePara elsevierViewextended">The following are the supplementary data related to this article.<elsevierMultimedia ident="ec0005"></elsevierMultimedia></p><p id="p0020" class="elsevierStylePara elsevierViewcompact-standard">Supplementary data to this article can be found online at <a href="https://doi.org/10.1016/j.mcpsp.2024.100467">https://doi.org/10.1016/j.mcpsp.2024.100467</a>.</p></span><span id="s0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0010">Consent for publication</span><p id="p0025" class="elsevierStylePara elsevierViewall">The patient or a legally authorized representative provided written informed consent for patient information and images to be published.</p></span><span id="s0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0015">Funding</span><p id="p0030" class="elsevierStylePara elsevierViewall">No funding.</p></span><span id="s0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="st0020">Authors' contributions</span><p id="p0035" class="elsevierStylePara elsevierViewall">EGC and DMS: Original idea, image acquisition, analysis and writing the original draft, review and editing. JMTM: Writing the original draft. COS: Image acquisition.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:4 [ 0 => array:2 [ "identificador" => "s0005" "titulo" => "Case description" ] 1 => array:2 [ "identificador" => "s0010" "titulo" => "Consent for publication" ] 2 => array:2 [ "identificador" => "s0015" "titulo" => "Funding" ] 3 => array:2 [ "identificador" => "s0020" "titulo" => "Authors' contributions" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2024-06-20" "fechaAceptado" => "2024-07-22" "multimedia" => array:2 [ 0 => array:8 [ "identificador" => "f0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1524 "Ancho" => 1423 "Tamanyo" => 224215 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0005" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">Transthoracic echocardiogram. A. Paraesternal short axis view at the great vessels in diastole. Bicuspid aortic valve with fusion of the right and left coronary cusps (white asterisk). B. Paraesternal short axis mitral view. Two separate mitral valve orifices were visualized; right (white arrow) and left orifice (red arrow). C. 3D transesophageal echocardiogram (multiplanar reconstruction); right (white arrow) and left orifice (red arrow). Two mitral orifices of equal size are shown. LA: left atrium, LV: left ventricle, RA: right atrium, RV: right ventricle, RVOT: right ventricular outflow tract. (For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.)</p>" ] ] 1 => array:8 [ "identificador" => "ec0005" "etiqueta" => "Supplementary Video 1" "tipo" => "MULTIMEDIAECOMPONENTE" "mostrarFloat" => false "mostrarDisplay" => true "detalles" => array:1 [ 0 => array:3 [ "identificador" => "al0010" "detalle" => "Supplementary Video " "rol" => "short" ] ] "Ecomponente" => array:3 [ "fichero" => "mmc1.mp4" "ficheroTamanyo" => 624543 "Video" => array:2 [ "flv" => array:5 [ "fichero" => "mmc1.flv" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] "mp4" => array:5 [ "fichero" => "mmc1.m4v" "poster" => "mmc1.jpg" "tiempo" => 0 "alto" => 0 "ancho" => 0 ] ] ] "descripcion" => array:1 [ "en" => "<p id="sp0010" class="elsevierStyleSimplePara elsevierViewall">3D transesophageal echocardiogram (multiplanar reconstruction). Double orifice mitral valve with equal opening and size in both orifices are shown.</p>" ] ] ] ] "idiomaDefecto" => "en" "url" => "/26039249/0000000700000004/v1_202410240709/S2603924924000429/v1_202410240709/en/main.assets" "Apartado" => array:4 [ "identificador" => "80822" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Imagen en medicina" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/26039249/0000000700000004/v1_202410240709/S2603924924000429/v1_202410240709/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2603924924000429?idApp=UINPBA00004N" ]
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