[Angiographic evaluation of mitral valve prolapse: my diagnostic criteria]

Diagnostic method of mitral valve prolapse (MVP) by left ventriculography was proposed. The results of the study are summarized as follows: 1) MVP was assessed by the dislocation of the mitral leaflets from their coaptation site. Diagnosis by left ventriculography was made by the characteristic "hook-like" finding at the coaptation site in the lateral view of the long axial oblique projection (LAP). MVP was classified into three groups by the degree of dislocation. 2) One hundred and twenty-eight patients with secundum atrial septal defect were examined. The diagnosis of MVP was agreed between cineangiography and real-time two-dimensional echocardiography in all the cases except two. On the other hand, by the right anterior oblique view, the diagnostic accuracy was at most 93%. 3) Cineangiographic diagnosis of MVP should be made by the tangential view to the mitral annulus. As to this point, RAO view has various problems and in the previous reports there seems to be some misinterpretations about the prolapse of this valve. For this tangential view, the lateral view of LAP is so useful that MVP must be assessed by this view.