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Figure 3 Mitral regurgitant jet with a "spiral" pattern in a patient with anterior prolapse. This jet is directed perpendicular to the mitral annulus, then it turns twice in direction (arrows), according to the curvature of the left atrial wall. The transverse section of the jet proximal to its origin has a circular shape. The arrowheads in the three-dimensional image at 60° show the reverse systolic flow in the left upper and lower pulmonary veins. Due to the particular direction of the regurgitant jet, the detection of reverse systolic pulmonary flow by pulsed Doppler does not indicate a severe degree of mitral regurgitation. LA = left atrium; LV = left ventricle.