A Case of Parachute Mitral Valve in an Adult

Parachute mitral valve is a rare congenital cardiac anomaly in which the chordae tendineae of both leaflets of the mitral valve insert into a single papillary muscle. We diagnosed a 54-year-old adult with dyspnea after upper respiratory infection, who was proven to have the parachute mitral valve. To the best of our knowledge, this is the oldest patient reported with this congenital anomaly. The clinical, echocardiographic and MRI findings are described. We recommended surgery for anomalous lesion, but the patient refused. After medical treatment, the patient recovered uneventfully and remained asymptomatic during a follow-up of 13 months.

Immediate and long-Term Results of Percutaneous Mitral Valvuloplasty Using the Inoue Balloon

BACKGROUND AND OBJECTIVES: The objective of this study was to assess the short- and long-term clinical outcomes and valvular changes after percutaneous mitral valvuloplasty (PMV) in Sejong Hospital. SUBJECTS AND METHOD: Four hundred sixty-seven patients received PMV (Ed-already defined above) using the Inoue Balloon at Sejong hospital from 1990 to 2002. Short and long-term results, restenosis-free survival rate and prognostic factors for each result were analyzed by Chi-square, Cox regression analysis, Life table method and Cox proportional hazard model. RESULTS: After PMV, mitral valve area increased from 0.94+/-0.21 cm2 to 1.76+/-0.37 cm2 and the success rate (MVA>1.5 cm2 or increased by at least 50% without the development of moderate to severe mitral regurgitation) was 78.9%. Age ( or =1.1 cm2, p=0.001) were independent favorable prognostic factors for short-term result. As for the development of moderate to severe mitral regurgitation, pre-procedural MVA (9, p=0.043) were independent predictive factors. Median restenosis-free survival was 82.98 months and the restenosis-free survival rate was 70.9% at 3 years post-PMV, 48.1% at 6 years and 29.6% at 10 years. The independent prognostic factor for restenosis-free survival rate was left atrial dimension (LAD or =1.0 cm2, p=0.24) and ejection fraction (EF> or =55%, p=0.146) had an effect on the good long-term results of PMV from multivariate analysis. CONCLUSION: PMV was a very successful treatment method for mitral stenosis. Pre-procedural MVA was a representative predictive factor for short and long-term outcomes and the development of mitral regurgitation.