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Isolated cleft mitral valve: valve reconstruction techniques

P Perier1, B Clausnizer

  • 1Herz und Gefäss Klinik, Bad Neustadt/Saale, Germany.

The Annals of Thoracic Surgery
|January 1, 1995
PubMed
Summary
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Isolated anterior mitral cleft, a rare congenital anomaly, presents with mitral insufficiency. Surgical repair may involve direct suturing or reconstruction with autologous pericardial patches, achieving good outcomes in patients.

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.

Related Experiment Videos

  • 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.