Flail Posterior MV Leaflet in the Context of Rheumatic Heart Disease

  • Atooshe Rohani
Part of the Clinical Cases in Cardiology book series (CCC)


Rheumatic heart disease (RHD) can lead to mitral regurgitation and stenosis, this case illustrates severe mitral regurgitation in the context of RHD.

RHD is the third most common etiology of chordal rupture.

Mechanism of mitral regurgitation in the context of RHD is a combination of excessive MV leaflet tip motion and annular dilatation.


Rheumatic heart disease Mitral regurgitation Flail mitral valve 

Supplementary material

Movie 18.1

Thickened AMVL and flail posterior MV leaflet (AVI 5365 kb)


  1. 1.
    Reményi B, Wilson N, Steer A, Ferreira B, Kado J, Kumar K, et al. World Heart Federation criteria for echocardiographic diagnosis of rheumatic heart disease—an evidence-based guideline. Nat Rev Cardiol. 2012;9(5):297–309.CrossRefGoogle Scholar
  2. 2.
    Kalangos A, Beghetti M, Vala D, Jaeggi E, Kaya G, Karpuz V, Murith N, et al. Anterior mitral leaflet prolapse as a primary cause of pure rheumatic mitral insufficiency. Ann Thorac Surg. 2000;69(3):755–61.CrossRefGoogle Scholar
  3. 3.
    Chauvaud S, Fuzellier JF, Berrebi A, Deloche A, Fabiani JN, Carpentier A, et al. Long-term (29 years) results of reconstructive surgery in rheumatic mitral valve insufficiency. Circulation. 2001;104(12 Suppl 1):I12–5.CrossRefGoogle Scholar
  4. 4.
    Skoularigis J, Sinovich V, Joubert G, Sareli P. Evaluation of the long-term results of mitral valve repair in 254 young patients with rheumatic mitral regurgitation. Circulation. 1994;90(5 Pt 2):II167–74.PubMedGoogle Scholar
  5. 5.
    Tomaru T, Uchida Y, Mohri N, Mori W, Furuse A, Asano K. Postinflammatory mitral and aortic valve prolapse: a clinical and pathological study. Circulation. 1987;76(1):68–76.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Atooshe Rohani
    • 1
  1. 1.Northern Ontario School of MedicineThunder BayCanada

Personalised recommendations