DK2985_C000 1..28 - AlSharqia Echo Club

388 Transesophageal Echocardiography(A)(B)P2P3P1LALVLAA(C)A1A2A3P1P2P390° (2 chamber post)Figure 17.7 Echocardiographic (A, B) and anatomical (C) representation of the mitral valve in the mid-esophageal two-chamber viewat 908 with slight counterclockwise posterior rotation of the transesophageal echocardiographic shaft towards the left (LA, left atrium;LAA, left atrial appendage; LV, left ventricle). (Photo C courtesy of Dr. Nicolas Dürrleman.)2. Etiology of Mitral RegurgitationIn a recent review of 1000 patients undergoing mitralvalve surgery for MR, 50% had valvular degenerescence,20% rheumatic disease, 17% ischemic regurgitation while8% of MR originated from infectious processes and theremaining 5% had miscellaneous causes. Identifying thecauses of MR has prognostic implication for long-termsurvival, being at six years 85% for floppy valve disease,64% for organic nonfloppy valve disease, and 46% forischemic or functional MR (7).In the following discussion, we will review the mainetiologies of MR.A. EndocarditisEchocardiography is an integral part of the clinical assessmentof a patient with suspected endocarditis. Theechocardiographic findings have been included in theDuke criteria for evidence of cardiac involvement (8)(Table 17.1).(A)(B)POSTEROMEDIAL COM.RVLVANTEROLATERAL COM.Figure 17.8 Echocardiographic representation of the mitral valve in the transgastric basal short-axis view at 08 (COM, commissure;LV, left ventricle; RV, right ventricle).