Isolated cleft mitral valve: valve reconstruction techniques

Area of Science:

• Cardiovascular Surgery
• Congenital Heart Disease
• Valvular Heart Disease

Background:

• Isolated cleft of the anterior mitral valve is a rare congenital anomaly.
• Clinical presentation typically includes symptoms of mitral insufficiency.
• Previous repair methods often involve direct suturing of the cleft edges.

Purpose of the Study:

• To report on the surgical management and outcomes of four cases with isolated anterior mitral cleft.
• To evaluate the efficacy of different repair techniques for this rare condition.

Main Methods:

• Preoperative echocardiography for precise anatomic diagnosis.
• Surgical repair techniques included direct suture or autologous pericardial patch reconstruction for the anterior mitral leaflet.
• Annuloplasty with a Carpentier mitral ring was performed in all cases.

Main Results:

• Four patients aged 13-41 years with mitral insufficiency due to anterior mitral cleft were treated.
• Direct suture was feasible in one patient; the other three required reconstruction due to fibrous tissue and tissue loss.
• Postoperative echocardiography showed excellent results, with one patient having trivial insufficiency and three having a competent mitral valve.

Conclusions:

• Surgical repair of isolated anterior mitral cleft is effective.
• Autologous pericardial patch reconstruction is a viable alternative when direct suturing is not possible.
• Combined repair with annuloplasty and a mitral ring yields favorable long-term outcomes.