Video Files

Files in this Data Supplement:

• S1C - Fig. S1C—Data sets are uploaded into specialized cardiac software. Multiplanar reformat lines are manually manipulated to pass through the center of mitral valve apparatus and left ventricular apex on two- and four-chamber views and through the middle of right ventricular free wall on the short-axis view. This results in short-axis view of the ventricles (upper left box); four-chamber view (lower left box); two-chamber view (upper right box); and 3D volumetric box (lower right box), simulating a ventriculogram.

• S2C - Fig. S2C—Three-chamber cine CT shows normal opening and closing of mitral valve leaflets. Note leaflet “flutter” corresponding to passive and active atrial flow during ventricular diastole.

• S3 - Fig. S3—Three-chamber cine CT shows extensive calcification of the posterior mitral annulus and restricted movement of the posterior mitral leaflet, resulting in mitral stenosis. Also, note calcification of the aortic cusps.

• S5C - Fig. S5C—Four-chamber cine CT shows prolapse of an atrial mass through the mitral valve orifice. Atrial myxoma was proven at surgery.

• S6C - Fig. S6C—Three-chamber cine CT shows prolapse of the posterior mitral leaflet into the left atrium with rupture of chordae tendineae from posterior papillary muscle.

• S7 - Fig. S7—Four-chamber cine CT shows incomplete coaptation of mitral valve leaflets during ventricular systole consistent with mitral regurgitation. Note enlarged left atrium. Echocardiography (not shown) confirmed severe mitral regurgitation.

• S9 - Fig. S9—Three-chamber cine CT shows severe prolapse of posterior mitral leaflet into left atrium and severe incomplete coaptation of mitral leaflets consistent with severe mitral regurgitation.

• S10C - Fig. S10C—Cine CT across the aortic valve shows wide opening of cusps during ventricular systole and complete coaptation in center of valve orifice during ventricular diastole.

• S11C - Fig. S11C—Three-chamber cine CT shows systolic anterior motion of anterior mitral valve leaflet with severe left ventricular outflow tract obstruction during ventricular systole.

• S12 - Fig. S12—Cine CT across aortic valve confirms restricted opening of aortic cusps consistent with moderate aortic stenosis.

• S13C - Fig. S13C—Cine CT across aortic valve confirms bicuspid aortic valve. Note elliptic shape of valve orifice in systole.

• S14 - Fig. S14—Cine CT across valve confirms bicuspid aortic valve with large, mobile vegetation that has eroded through aortic wall with subsequent extravasation. Findings were confirmed at surgery.

• S15 - Fig. S15—Three-chamber cine CT shows two flail aortic cusps with vegetations. Surgery confirmed valve leaflets were completely destroyed. Blood cultures grew Staphylococcus aureus.

• S16 - Fig. S16—Four-chamber cine CT shows apical displacement of septal leaflet of tricuspid valve, with reduced motion of anterior leaflet, resulting in tricuspid regurgitation and enlargement of right atrium and characteristic “ping-pong” volume distribution of right heart.

• S18C - Fig. S18C—Four-chamber cine CT shows immobile, fixed anterior tricuspid leaflet; thickened chordae tendineae; and enlarged right atrium from tricuspid stenosis secondary to cardiac carcinoid. Findings were confirmed on echocardiography (not shown).