case_images: PMC3891162_01
case_images: Transesophageal view of the two separated mitral orifices at 82 . (A) The fibrous bridge (arrow) divides the mitral orifice into the posteromedial P; and the anterolateral A; openings, and each orifice has its own chordae tendinae tethered to a different papillary muscle. (B) During diastole, the color flow image reveals a distinct mitral inflow jet flowing through each of the 2 orifices.
case_images: kjim-20-251-g001.jpg
case_images: PMC3891162_01_kjim-20-251-g001.jpg
case_images: F1
case_images: It is interesting that each orifice had its own chordae tendineae tethered to a different papillary muscle (Figure 1A, 1B).
case_images: The transgastric view of the two mitral orifices at 37 . The larger posteromedial P; and smaller anterolateral A; orifices are clearly identified.
case_images: kjim-20-251-g002.jpg
case_images: PMC3891162_01_kjim-20-251-g002.jpg
case_images: F2
case_images: The transgastric short axis view revealed a larger posteromedial orifice and a smaller anterolateral orifice (Figure 2).
case_images: The transesophageal images taken from the long axis view of the left atrium and the left ventricle at 90 . (A) During systole, the flail posterior leaflet of the anterolateral orifice is demonstrated. (B) The color Doppler shows very eccentric mitral regurgitation at this site. LA; indicates left atrium; LV; indicates left ventricle.
case_images: kjim-20-251-g003.jpg
case_images: PMC3891162_01_kjim-20-251-g003.jpg
case_images: F3
case_images: At the level of anterolateral orifice, the color Doppler revealed moderate to severe eccentric regurgitation due to the flail posterior leaflet (Figure 3A, 3B).
case_images: The transthoracic right ventricular inflow view. The air bubbles are visible in right atrium through the coronary sinus ( ).
case_images: kjim-20-251-g004.jpg
case_images: PMC3891162_01_kjim-20-251-g004.jpg
case_images: F4
case_images: No other congenital cardiac anomalies were noted except for the persistent left superior vena cava that was demonstrated by injecting agitated saline at the antecubital vein of the left arm (Figure 4).