ABSTRACT
We experienced 2 cases of accessory mitral valve tissue (AMVT). Case 1 : A 56-year-old man was admitted with aortic regurgitation. Transthoracic and transesophageal echocardiography revealed AMVT with no left ventricular outflow tract obstruction. The patient underwent a successful aortic valvuloplasty. AMVT was carefully excised, because we suspected AMVT might be the cause of recurrent aortic regurgitation and left ventricular outflow tract obstruction with aging. Case 2 : A 63-year-old woman was admitted with mitral regurgitation due to infective endocarditis. During medical treatment, transthoracic and transesophageal echocardiography revealed membranous structure in the left atrium uneffected by antibiotics. Mitral valvuloplasty and resection of membranous structure was performed. The membranous structure was not vegetation and had no relationship to mitral regurgitation. Pathological examination proved AMVT. To our knowledge, this is the first report of AMVT in left atrium in an adult.
ABSTRACT
Objective To describe the echocardiographic and clinical findings of patients with accessory mitral valve(AMV).Methods Four adult patients were diagnosed to have AMV by Doppler echocardiography.Results All the four patients had cardiac murmur but 2 were asymptomatic.Echocardiogram showed that two cases had isolated AMV with significant left ventricular outflow tract (LVOT)obstruction.Another patient was complicated by idiopathic hypertrophic subaortic stenosis and his systolic pressure gradient across the LVOT reduced to normal after taking negative inotropic drugs.The fourth patient was associated with complex congenital cardiac anomalies but without LVOT obstruction.Conclusions AMV may not be very rare as previously reported.An echocardiographic examination Can detect AMV and difierentiate it from other causes of LVOT obstruction.
ABSTRACT
Accessory mitral valve tissue is a very rare congenital cardiac malformation and it is an uncommon cause of left Ventricular outflow tract obstruction (LVOTO). The pathogenetic mechanism of subaortic obstruction is thought to be systolic ballooning of the abnormal valve tissue into LVOT. We are reporting a case of an accessory mitral valve tissue that was associated with LVOTO, and this was completely relieved after trans-aortic surgical excision of the accessory tissue.
Subject(s)
Mitral ValveABSTRACT
Objective To study the clinical characteristics and surgical treatment of left ventricular outflow tract obstruction (LVOTO) caused by congenital accessory mitral valve (AMV) tissue. Methods Two cases were treated in our department. Pre-operatively, case 1 was diagnosed as congenital heart disease with severe LVOTO and anterior mitral valve cleft; case 2 was diagnosed as congenital atrial septal defect combined with AMV and mild LVOTO as well as mild mitral valve regurgitation. Both patients were operated on under CPB. In case 1, LVOTO was caused by AMV which belonged to Type I (fixed type). In case 2, the AMV was type II (mobile type). Results Both AMV tissues were resected through atrial septum, and combined cardiac disorders were repaired simultaneously. The operations were successful and the patients were discharged with good results. Echocardiography revealed that the LVOTO almost disappeared. Conclusions LVOTO caused by AMV is a rare congenital heart disorder. AMV may be removed with acceptable postoperative outcome. Prophylactic removal of AMV tissue should not be attempted in patients with no or mild LVOTO and no other associated heart defects. These patients should be followed and observed periodically by Doppler echocardiography to identify any progression in LVOTO.