Tri-leaflet mitral valve in hypertrophic obstructive cardiomyopathy.

Area of Science:

• Cardiology
• Cardiac Surgery
• Genetics

Background:

• Tri-leaflet mitral valve (MV) is an exceptionally rare anomaly.
• It is frequently linked to significant mitral regurgitation (MR).
• This condition may manifest as a phenotypic expression of hypertrophic obstructive cardiomyopathy (HOCM).

Purpose of the Study:

• To present a unique case of HOCM with a tri-leaflet MV and severe MR.
• To illustrate the successful surgical management of this rare presentation.
• To highlight the relationship between MV anatomy, HOCM, and MR.

Main Methods:

• Case report of a 69-year-old woman with HOCM, tri-leaflet MV, and SAM-induced severe MR.
• Medical therapy was optimized, but symptoms persisted.
• Surgical myectomy was performed due to refractory symptoms and significant MR.

Main Results:

• The surgical myectomy improved left ventricular outflow tract obstruction.
• Systolic anterior motion (SAM)-induced severe MR was significantly reduced.
• The patient experienced substantial symptomatic relief post-surgery.

Conclusions:

• This case highlights a rare coexistence of HOCM and a tri-leaflet MV.
• Tailored surgical myectomy proved effective in managing severe MR and obstruction.
• The findings underscore the importance of considering rare MV anomalies in HOCM.