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Transcript of the video: Closure line of aortic valve on M-Mode echocardiogram, is seen as central line, while in bicuspidaortic valve, it is an eccentric closure, nearer to one of the walls of the aorta. This eccentricity of closure of the aortic valve leaflets, can be calculated using what is known as eccentricity index.
In this view, you can see that mitral leaflets are thickened. This is anterior mitral leaflet, thickened, and in the closed position of mitral valve, when there should be no flow to the left atrium, you are seeing a jet, a mosaic jet, which has been traced out. This is the mitral regurgitation jet. Here it is the AR jet.
Here, this is the forward flow through the mitral valve in diastole in red. This is reverse flow from the aortic valve, that is aortic regurgitation jet. Area of the jet corresponding to the receiving chamber, that is left atrium, that is also deciding factor in assessing the severity of mitral regurgitation.
Mitral valve leaflets seen in open position between the left ventricle and left atrium are thickened. The large aortic regurgitation jet can be seen as a mosaic jet in the left ventricular outflow tract anterior to the anterior mitral leaflet. Aortic valve is seen as grossly thickened and calcified.
Here, this is the forward flow through the mitral valve in diastole in red. This is reverse flow from the aortic valve, that is aortic regurgitation jet. Area of the jet corresponding to the receiving chamber, that is left atrium, that is also deciding factor in assessing the severity of mitral regurgitation.
Unlike the valves on the left side like the mitral and aortic, right sided valves can have some leak. That is, mild mitral regurgitation and mild aortic regurgitation are less common. But even in nearly normal persons, there could be a little bit of leak in the tricuspid valve. Similar leaks on the left side are less.
This is the aortic valve in closed position and mitral valve also appears to be closed in position. From the images you do not know whether the mitral valve is really fully closed or almost about to be closed. You can also see the aortic override. Separation between the attachments of the aortic and mitral valve.
Transcript of video: Hypoplastic Left Heart Syndrome is a very severe form of congenital heart disease, in which, the left ventricle, aorta and mitral and aortic valves are hypoplastic and valves may be atretic as well. It has a very poor survival. This is diagrammatic representation of hypoplastic left heart syndrome.
Right ventricular outflow tract, left ventricle, left atrium, aorta, aortic valve, mitral valve. Location of the transducer here, in the parasternal region. This is the parasternal long axis view. These are the things you have seen in that inset image. This is movement of the anterior wall of the right ventricle.
Tracing in the lower part is tissue Doppler imaging from the medial mitral annulus. Opening and closing movements of the aortic and mitral valves are visible. Slight downward angulation of the transducer from this view gives the left ventricular cross section with mitral valve cross section within.
So that is why we see straightening of left border, typically heard of in mitral stenosis with left atrial enlargement and mild pulmonary hypertension. When there are bulges, aortic knuckle is first mogul, main pulmonary artery segment is second mogul, and left atrial appendage is taken as the third mogul sign.
When there is ectopy, there is a chance for spurious mitral regurgitation to occur during left ventriculography. So it will not produce a true LV to aorta pullback tracing, which is required in cases like aortic stenosis. When the tip is in the left ventricle, this region will be in the aorta sometimes.
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