Garden-Hose Mitral Regurgitation: A Variant That Can Result in Underestimation of Severity: A Multimodality Imaging Case Study

J Cardiothorac Vasc Anesth. 2022 Jul;36(7):2232-2236. doi: 10.1053/j.jvca.2022.02.033. Epub 2022 Mar 2.

Abstract

The quantitative assessment of mitral regurgitation (MR) by echocardiography has limitations. Cardiac magnetic resonance (CMR) imaging has an emerging role in the quantitation of MR, and preliminary studies indicate that CMR assessment may more accurately quantify MR and better correlate with postsurgical left ventricular reverse remodeling. The authors here report a case of MR in which multimodality imaging with CMR and transesophageal echocardiography was crucial in accurately diagnosing the severity of MR when transthoracic and provocative supine bike echocardiography underestimated the degree of MR in a unique variant known as "garden-hose" MR.

Keywords: Garden Hose effect; cardiac magnetic resonance imaging; mitral regurgitation; mitral valve prolapse; multimodality imaging.

Publication types

  • Case Reports

MeSH terms

  • Echocardiography
  • Gardens
  • Humans
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Mitral Valve Insufficiency* / diagnostic imaging
  • Mitral Valve Insufficiency* / surgery
  • Predictive Value of Tests
  • Severity of Illness Index
  • Ventricular Remodeling