[Mitral valve prolapse and atrial septal defect of the secundum type. Clinical aspects, angiocardiography and echocardiography].

In 31 patients with secundum-type atrial septal defect (ASD II) and mitral valve prolapse (MVP), the reliability of an angiocardiographic MVP diagnosis was investigated by angio-, echo-, phono- and electrocardiography. The MVP assessment resulted from calculating the prolapse area on cine-films and measuring the dorsal motion of mitral leaflets on echocardiograms. Angiocardiographic diagnosis of MVP found a correlation no higher than 62.5% with echocardiographic diagnosis. In most cases the MVP intensity in echocardiograms was lower by 1-2 degrees. Phonocardiographic diagnosis differed from the angiographic (71% agreement, negative correlation) but corresponded well (80.0%) with the echocardiographic. Electrocardiographic results were not usable. Echocardiographic diagnosis would therefore seem to be the best method in the case of MVP. Use of insufficient left-ventricular contrast medium may--as observed in one patient--lead to the simulation of an MVP. Pre- and postoperative results point to the fact that an MVP is recurrent after ASD II closure. Certain irregularities of right-left-ventricular border seem to correspond with prolapsed medial scallops.