Two patterns of the “crossed swords sign” for the accurate diagnosis of diverse mitral valve regurgitations

Abstract

The “crossed swords sign,” demonstrating the divergent jet, is visualized on 2-dimensional color Doppler imaging and indicates complicated mitral regurgitation (MR). We describe the cases of two patients with varying patterns of the crossed swords sign. In the first patient, the crossed swords sign was detected during the holosystolic phase. In the second patient, the direction of the MR jet changed according to the phase of systole: The crossed swords sign was formed by two regurgitation jets during different phases of systole. The crossed swords sign implies two patterns and is useful for the accurate diagnosis of complex MR.

Commissure leaflet prolapse closely mimics anterior mitral leaflet perforation in 2-D image of transesophageal echocardiography

“…1 , white arrows). The presence of two regurgitant jets, known as the “crossed sword sign,” suggests the presence of complex lesions [ 4 , 5 ]. Additionally, In ME-4-chamber view, only one regurgitation orifice was observed on the left ventricular side, originating from the regurgitation jet of A3 (Fig.…”