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European Heart Journal 1983 4(7):472-476;
Copyright © 1983 by the European Society of Cardiology.
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© 1983, by the European Society of Cardiology

Prolapse of the mitral valve in secundum atrial septal defect: A functional mechanism

M. BALLESTER, Clinical Assistant of the National Heart Hospital*, P. PRESBITERO{dagger}, R. FOALE{ddagger}, A. RlCKARDS§, and L. McDONALD§

The National Heart Hospital London W1M 8BA, U.K.
*Fellow of the Cardiothoracic Institute and in receipt of a grant from the Pollitzer Fund
{dagger}The Hospital for Sick Children Great Ormond Street, London WC1
{ddagger}Hammersmith Hospital Du Cane Road, London W12 OHS
§The National Heart Hospital Westmoreland Street, London W1M 8BA

Received 22 March 1982; revised 11 November 1982; .

Address for reprints: Dr Anthony Rickards, National Heart Hospital, Westmoreland Street, London W1M 8BA, U.K.

Abstract

Prolapse of the mitral valve in patients with secundum atrial septal defect has been described angio-graphically and by two-dimensional echocardiography. It has been suggested that prolapse of the mitral valve in these patients is due to distortion of left ventricular shape and small left ventricular volume. To test this hypothesis 10 patients with unrepaired secundum atrial septal defect and 10 patients who had undergone repair of the defect were studied by two-dimensional echocardiography. The prevalence of mitral valve prolapse was 80% in the unrepaired group and 20% in the repaired group (P<0.01). Short axis of the left ventricle revealed septal bulging into the left ventricle, the end-diastolic ratio of minor to major axis being 0.71 in the unrepaired group and 0.93 in the repaired group (P<0.001). Systolic and diastolic cross-sectional areas were larger in the repaired group compared with the unrepaired group (P<0.05). Prolapse of the mitral valve in patients with secundum atrial septal defect may be related to the distorted left ventricular shape and small left ventricular volume.

Key Words: Congenital heart disease • atrial septal defect • mitral valve • prolapse mitral valve • left ventricle • two-dimensional echocardiography


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