Download ASE/SCA Mitral Valve Terminology

ASE/SCA Mitral Valve Terminology
The American Society of Echocardiography/Society of Cardiovascular Anesthesiologists in their 1999
“Guidelines for Performing a Comprehensive Intraoperative Multiplane Transesophageal
Echocardiography Examination” defined terminology nomenclature for the mitral valve (Figure 1).
They elected to use the Carpentier numbering system (A1,A2,A3,P1,P2,P3) of the mitral leaflet, but made
significant changes in how the anterior leaflet portions were defined. The ASE/SCA anatomic
nomenclature of the mitral valve: A1, the lateral third of the anterior leaflet; A2, the middle third of the
anterior leaflet; A3, the medial third of anterior leaflet; P1, lateral scallop of posterior leaflet,; P2, middle
scallop of posterior leaflet; P3 medial scallop of posterior leaflet (Figure 1). The commissural portions
are termed anterolateral commissure and posteromedial commissure.
Note that this differs from Carpentier terminology. In Carpentier’s terminology A1, A2, and A3 are
defined by where P1, P2, and P3 co-apt with the anterior leaflet, not a random division of the anterior
leaflet into thirds (see section on Carpentier terminology). A subtle, but significant difference.
The ASE/SCA terminology is primarily a mitral valve leaflet terminology and does not address
LV-Papillary-Chordal -Leaflet relationships.
Anatomy of mitral valve. A1, Lateral third of the anterior leaflet; A2, middle third of the anterior leaflet;
A3, medial third of the anterior leaflet; P1, lateral scallop of the posterior leaflet; P2, middle scallop of
the posterior leaflet; P3, medial scallop of the posterior leaflet.