Mitral valve endocarditis can affect any part(s) of the mitral valve apparatus – annulus, leaflets, and even chordae tendinae – resulting in acquired mitral valve regurgitation (MR) through leaflet perforation, rupture of chordae, and other damage to the leaflets.
3D transesophageal echocardiography (TEE) is incredibly powerful in diagnosing the mechanism of MR in these situations. In this 3D “en-face” view of the mitral valve, one can appreciate a large perforation in the anterior leaflet of the mitral valve (ALMV) and a probable cleft in the posterior leaflet.
