Types

Leaflet motion

Mechanism

Type 1

Normal motion

Annular dilation, clefts, leaflet perforation

Type II

Excessive motion

Prolapse, flail chords, ruptured papillary muscle

Type III

Restricted motion

Type IIIa

Restriction during diastole and systole

Commissural fusion due to rheumatic heart disease

Type IIIb

Restriction during systole only

Chordal tethering, papillary musle displacement