Mitral cleft in ostium primum atrial septal defect assessed by cross-sectional echocardiography

We attempted to detect mitral deformities in ostium primum atrial septal defect using real-time cross-sectional echocardiography. Transverse sections of the anterior mitral leaflet echo were examined in 11 patients with this malformation who subsequently received surgical treatment. The section for observing the transverse view of te anterior leaflet was along the sagittal plane of the body, because of the deformity of the mitral annulus. Each echocardiographic finding was compared with the surgical and angiographic findings. On the echocardiogram, the superior and inferior parts of the anterior mitral leaflet separated into two parts during diastole in all patients with mitral cleft. Thin linear echoes connected the ridges of the cleft and the ventricular septum in seven patients in whom the accessory chordae at that area were revealed at surgery. The systolic configuration of the anterior leaflet echo varied among the patients. The severity of the miral regurgitation seemed to relate not only to the size of the cleft but also to the systolic configuration of the anterior mitral leaflet. After surgery, diastolic separation of the anterior leaflet echo was no longer observed. However, the abnormal systolic configuration of the anterior leaflet was unchanged.