Anatomy and echocardiography of the normal and abnormal mitral valve

Unlike the tricuspid valve, the mitral valve has frequently received the attention of anatomists. Indeed, the drawings made by Leonardo da Vinci still retain their currency,¹ whilst it was no less a personage than Andreas Vesalius who, as far as we know, first likened the bifoliate appearance of the valve to the Episcopal mitre. It was also Vesalius who recommended that the two leaflets be described as aortic and mural, reflecting their respective relationships to the aortic valve and the parietal atrioventricular junction. It was Roberts and Perloff,² however, who emphasized the necessity, for clinical purposes, of analyzing not only the valvar leaflets, but also the overall valvar complex. As we will demonstrate in our review, this approach to analysis also proves its worth for the echocardiographic recognition of the congenitally malformed valve.