If the MR jet is directed centrally, which prolapse pattern is most likely?

If the MR jet is directed centrally, which prolapse pattern is most likely?

• A. Anterior leaflet prolapse
• B. Posterior leaflet prolapse
• C. Normal valve without prolapse
• D. Both leaflets prolapse

Answer: (D)

The central MR jet points to a regurgitant orifice located near the center of the mitral valve, which happens when both leaflets fail to coapt centrally. That pattern fits bileaflet prolapse, where prolapse of both leaflets creates a central path for regurgitant flow. If only one leaflet were prolapsing, the jet would usually be eccentric, directed toward the atrial wall opposite the prolapsing leaflet, because the regurgitant orifice is off-center. So a centrally directed jet best indicates prolapse of both leaflets.

The central MR jet points to a regurgitant orifice located near the center of the mitral valve, which happens when both leaflets fail to coapt centrally. That pattern fits bileaflet prolapse, where prolapse of both leaflets creates a central path for regurgitant flow. If only one leaflet were prolapsing, the jet would usually be eccentric, directed toward the atrial wall opposite the prolapsing leaflet, because the regurgitant orifice is off-center. So a centrally directed jet best indicates prolapse of both leaflets.