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Fig. 3 —Images in 10% step reconstructions of R-R interval in
perpendicular long-axis plane show dynamic morphology of mitral valve
throughout one cardiac cycle. Plane through middle of valve was chosen for
visualization of valve motion. At 5%, valve is closed, and anterior (white
arrowhead) and posterior (black arrowhead) leaflets are opposed
to each other at apposition zone (black arrow). Note attachment of
leaflets to mitral annulus (white arrows). At 15% and 25%, slight
flattening of leaflets (white and black arrowheads) can be
depicted, while edges are still opposed to each other (black arrow).
In transitional phase (35% and 45%), both leaflets open toward ventricle
(large white arrows). One head of posteromedial papillary muscle and
tendinous cord attaches to free edge of posterior leaflet (45%, small
white arrows). After maximal opening (55%), leaflets (white and
black arrowheads) exhibit to-and-fro movement until another opening
impulse occurs (65% and 75%). At 85%, rapid valve closure can be seen with
bulging of leaflets (white and black arrowheads) until
approximating each other at late diastole (95%). Note excellent image quality
for showing leaflets during valve closure and maximal opening and slight
reduction of image quality during rapid movements in transitional phases.
Because of orientation of long-axis plane, up- and downward movements of whole
valve apparatus together with intrinsic valve movements can be visualized on
single reconstruction.
