Cross-sectional echocardiographic study on the mitral valve prolapse associated with secundum atrial septal defect: pre- and post-operative comparison

Cross-sectional echocardiography was performed on 77 patients with secundum atrial septal defect (ASD). Mitral valve prolapse (MVP) was recognized in 41 out of the 77 (53.2%); anterior MVP was found in 36 patients, three cases revealed posterior MVP, and two were diagnosed as having both anterior and posterior MVP. Pre- and post-operative study was carried out on 53 cases; anterior MVP decreased in incidence from 28 patients to 17 following closure of ASD, whereas posterior MVP remained unchanged, as did both anterior and posterior MVP. The left ventricular distortion ratio (LVDR) was measured in the short axis view in 45 cases. After the repair of ASD, the LVDR decreased both in end-systole and end-diastole (p less than 0.01), that is, the left ventricle became more circular in configuration. Pre- and post-operatively, MVP patients revealed a significantly greater LVDR than those without it in end-systole, and post-operatively in end-diastole as well (p less than 0.01). Prior to operation, the short axis area of the left ventricle (LVSAA) was statistically larger in patients with MVP than without it in end-diastole (p less than 0.05). However, there existed no relationship between the presence of MVP and the pulmonic to systemic flow ratio, right ventricular dimension index, right ventricular systolic pressure and size of ASD at the time of operation.