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Accessory mitral valve tissue causing left ventricular outflow tract obstruction: case reports and literature review
E Prifti1, G Frati, M Bonacchi
1G. Pasquinucci Hospital, CREAS-IFC-CNR, Massa, Italy.
The Journal of Heart Valve Disease
|January 5, 2002
Summary
Accessory mitral valve (AMV) tissue can cause left ventricular outflow tract obstruction (LVOTO). Surgical removal is effective for symptomatic LVOTO, but prophylactic removal is not recommended for mild cases.
Area of Science:
- Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Accessory mitral valve (AMV) tissue is a rare congenital anomaly.
- It can lead to significant left ventricular outflow tract obstruction (LVOTO).
Observation:
- Three surgical cases of AMV tissue with LVOTO are presented.
- Literature review identified 87 additional cases, leading to a classification system (Type I and II).
- One infant case resulted in mortality due to progressive heart failure post-surgery.
Findings:
- Surgical excision of AMV tissue causing LVOTO yielded acceptable outcomes in adult patients.
- Conservative management with Doppler echocardiography is advised for asymptomatic or mildly obstructed cases.
- Prophylactic removal in patients without significant LVOTO or other defects is not recommended.
Implications:
- Timely surgical intervention for symptomatic AMV-related LVOTO can improve patient outcomes.
- Serial echocardiographic monitoring is crucial for detecting progression of LVOTO in select patients.
- This study refines management strategies for accessory mitral valve tissue, balancing surgical risks and benefits.