title: Demonstration of mitral valve prolapse with CT for planning of mitral valve repair.
abstract: Mitral valve prolapse (MVP), the most frequent cause of severe nonischemic mitral regurgitation, often warrants surgical or interventional valve repair. The severity of mitral regurgitation positively correlates with the development of heart failure and death. Even in patients who are asymptomatic, severe mitral regurgitation causes higher rates of death, heart failure, and atrial fibrillation. Repair procedures for mitral regurgitation have progressed to include leaflet repair, chordal transfer, ring or band annuloplasty, and new percutaneous procedures. In planning for mitral valve repair, detection and localization of mitral valve abnormalities are important. The causes of mitral regurgitation include degenerative mitral valve (eg, prolapsed leaflet, myxomatous degeneration, and Barlow disease [excessive degenerated tissues with elongated chordae]). Cardiac computed tomography (CT) is helpful for depicting mitral valve abnormalities. It allows complete visualization of cardiac anatomic features, including the coronary arteries, paravalvular structures, and cardiac wall motion. This review addresses the role of cardiac CT in depicting anatomic features of the mitral valve, provides a practical method for localizing the exact site of MVP, and discusses the CT findings of various causes of mitral regurgitation. The first step in reconstructing CT images for MVP is to select the best cardiac phase for depicting the anatomic features of the mitral valve. Additional views of the mitral valve then show the specific mitral valve abnormality. This article provides technical tips for demonstrating MVP with CT, as well as imaging results for various causes of MVP and intraoperative findings. Online supplemental material is available for this article.
authors.affiliation: From the Department of Radiology and Research Institute of Radiology (H.J.K., D.H.Y., S.Y.O., J.W.K., T.H.L.), Division of Cardiology (D.H.K., J.K.S.), and Department of Cardiovascular Surgery (J.W.L., C.H.C.), Cardiac Imaging Center, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Seoul 138-736, South Korea.
authors.forename: Hyun Jung
authors.initials: HJ
authors.lastname: Koo
authors.forename: Dong Hyun
authors.initials: DH
authors.lastname: Yang
authors.forename: Sang Young
authors.initials: SY
authors.lastname: Oh
authors.forename: Joon-Won
authors.initials: JW
authors.lastname: Kang
authors.forename: Dae-Hee
authors.initials: DH
authors.lastname: Kim
authors.forename: Jae-Kwan
authors.initials: JK
authors.lastname: Song
authors.forename: Jae Won
authors.initials: JW
authors.lastname: Lee
authors.forename: Cheol Hyun
authors.initials: CH
authors.lastname: Chung
authors.forename: Tae-Hwan
authors.initials: TH
authors.lastname: Lim
mesh_terms: D004452:Echocardiography; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging*; D010347:Patient Care Planning; D014057:Tomography, X-Ray Computed / Q000379:methods*