(A) The left atrium is visualised from the top. There are a small single eccentric
orifice and no separation of leaflets in diastole. (B) The valve is bulging into the
left atrium. Elongated papillary muscles attach directly to valve leaflets. Cardiac
CT: Two-chamber view (C). Abnormal position of the two elongated papillary muscles
that attach directly to valve leaflets. No chordae tendinae. (D) Excised mitral arcade:
view from left ventricular side. Complete fusion of both leaflets creating a very
thick central ridge: the arcade. No primary and secondary chordae tendinae.
Abbreviations: Co, tertiary chordae tendinae; O, eccentric single orifice; P, tips
of papillary muscles; CT, computed tomography; TEE, transoesophageal echocardiography;
3D, three dimensional.