Which Carpentier type is associated with increased leaflet motion due to chordal elongation or rupture?

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

Answer: (C)

Carpentier’s classification looks at how the mitral valve leaflets move. The key distinction is normal, excessive, or restricted motion. Increased leaflet motion happens when the supporting chordae tendineae are damaged—elongated or ruptured—allowing the leaflets to prolapse into the left atrium. This pattern defines Type II, the category for excessive leaflet motion or prolapse.

Type I describes normal leaflet motion with problems from the annulus or leaflets themselves not moving abnormally. Type IIIa and IIIb describe restricted motion, with IIIa restricted in both systole and diastole (often rheumatic) and IIIb restricted mainly in systole (often due to ischemic tethering).