Double-orifice mitral valve is an uncommon anomaly of the mitral valve with a single fibrous annulus with 2 orifices opening into the left ventricle. Three major types of this anomaly are recognized: (1) the eccentric or hole type (accounting for about 85%), (2) the central or bridge type (about 15%), and (3) duplicate mitral valve, which involves 2 mitral valve annuli and valves, each with its own set of leaflets, commissures, chordae, and papillary muscles. However, some echocardiographic artifacts also may lead to interesting appearances. The duplicating of cardiac valves by refraction of the ultrasound beam or mirror images has rarely been reported. The authors present the duplication of a moving mitral valve associated with an echocardiographic refraction artifact.
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