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Recognition and management of accessory mitral tissue causing severe subaortic stenosis
E P Ow1, S Y DeLeon, J E Freeman
1Department of Pediatrics, Loyola University Medical Center, Maywood, IL 60153.
The Annals of Thoracic Surgery
|April 1, 1994
Summary
Accessory mitral tissue can cause severe subaortic stenosis in children. Surgical excision of this tissue offers a curative solution, preventing obstruction recurrence and improving outcomes.
Area of Science:
- Pediatric Cardiology
- Congenital Heart Disease
- Cardiac Surgery
Background:
- Subaortic stenosis can arise from accessory mitral tissue, a condition often overlooked.
- Misdiagnosis can lead to ineffective surgeries, persistent obstruction, or fatal outcomes.
Observation:
- Two pediatric cases of severe subaortic stenosis caused by accessory mitral tissue were treated over 12 months.
- Echocardiography revealed accessory mitral tissue attached to the anterior mitral leaflet in one patient.
- In the second patient, subaortic stenosis developed later, attributed to accessory mitral tissue forming a tight ring.
Findings:
- Excision of accessory mitral and associated fibrous tissues effectively relieved subaortic obstruction in both patients.
- Post-operative echocardiography confirmed no significant residual left ventricular outflow gradient.
- Both patients experienced uneventful recovery and hospital courses.
Implications:
- Increased awareness and advanced echocardiography are crucial for recognizing accessory mitral tissue causing subaortic stenosis.
- Simple resection of accessory mitral tissue provides a curative treatment for this condition.
- Early and accurate diagnosis can prevent surgical complications and improve patient prognosis.