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Accessory mitral valve leaflet in an adult with coronary artery disease
E Prifti1, M Bonacchi, G Frati
1Institute of Heart and Great Vessels Surgery, La Sapienza University of Rome, Rome, Italy.
Insights
Accessory mitral valve leaflet, a rare cause of left ventricular outflow tract obstruction, was surgically excised in a 60-year-old man. This case highlights successful surgical intervention for this uncommon cardiac anomaly.
Area of Science:
- Cardiology
- Cardiac Surgery
- Congenital Heart Disease
Background:
- Accessory mitral valve leaflet is an exceptionally rare congenital cardiac anomaly.
- It can lead to significant left ventricular outflow tract (LVOT) obstruction.
- Surgical management is often necessary for symptomatic cases.
Observation:
- A 60-year-old male presented with coronary artery disease and moderate LVOT obstruction.
- The obstruction was attributed to a parachute-shaped accessory mitral valve leaflet.
- Detailed anatomical description included attachments to accessory papillary muscles and the anterior mitral valve leaflet.
Findings:
- The patient underwent successful coronary artery bypass grafting (2 vessels) and accessory leaflet excision.
- Post-operative outcomes were favorable, with relief of LVOT obstruction.
- A review of 21 similar cases was included.
Implications:
- This case underscores the importance of considering rare cardiac anomalies in the differential diagnosis of LVOT obstruction.
- Surgical excision of accessory mitral valve leaflets can be a safe and effective treatment.
- Further case series contribute to understanding the surgical approach and outcomes for this rare condition.
Abstract:
Accessory mitral valve leaflet is a very rare cause of left ventricular outflow tract obstruction. We report a patient presenting this cardiac abnormality who undergone cardiac surgery. A 60-year-old man, presented coronary artery disease and moderate left ventricular tract obstruction due to accessory mitral valve leaflet. The accessory mitral valve leaflet had the typical morphology of a parachute-shaped attached partially to the anterior mitral valve leaflet, with chordae tendinae attached to: 1) an accessory papillary muscle inserted at the free-wall closed to the apex; 2) interconnected with the chordae tendinae of the anterior mitral valve leaflet; 3) a second accessory papillary muscle inserted to the interventricular septum. He underwent successful coronary revascularization of 2 vessels and accessory leaflet excision. A review of 21 cases with accessory mitral valve leaflet is reported.