In Carpentier nomenclature, MR caused by annular dilation with normal leaflet motion is classified as which type?

In Carpentier nomenclature, MR caused by annular dilation with normal leaflet motion is classified as which type?

• A. Type II
• B. Type I
• C. Type IIIa
• D. Type IIIb

Answer: (B)

The key idea is that Carpentier classification groups mitral regurgitation by how the leaflets move. When the leaflets themselves move normally but regurgitation occurs because the annulus has dilated, the problem is annular dilation rather than leaflet dysfunction. That is Type I. In this type the valve leaflets coapt normally in systole, but the enlarged annulus prevents complete closure. By contrast, Type II involves prolapse or flail with excessive leaflet motion, and Type III involves restricted leaflet motion—Type IIIa in both systole and diastole (often rheumatic) and Type IIIb with restriction mainly in systole due to tethering from LV dilation or papillary muscle displacement.

The key idea is that Carpentier classification groups mitral regurgitation by how the leaflets move. When the leaflets themselves move normally but regurgitation occurs because the annulus has dilated, the problem is annular dilation rather than leaflet dysfunction. That is Type I. In this type the valve leaflets coapt normally in systole, but the enlarged annulus prevents complete closure. By contrast, Type II involves prolapse or flail with excessive leaflet motion, and Type III involves restricted leaflet motion—Type IIIa in both systole and diastole (often rheumatic) and Type IIIb with restriction mainly in systole due to tethering from LV dilation or papillary muscle displacement.