Accessory mitral leaflet: an uncommon form of subaortic stenosis

Pavione, Marcos Alves; Mendonça, José Teles de; Souza, Ivan Sérgio Espínola; Russo, Maria Amélia

doi:10.5935/1678-9741.20120080

Cited by 4 publications

(3 citation statements)

References 5 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Accessory mitral valve tissue arises from the anterior mitral leaflet and causes LVOT obstruction. Transthoracic echocardiography and TOE are considered the primary imaging modalities for AMVT diagnosis and patient follow-up 3 . We performed TTE and TOE that revealed AMVT attached to the anterior mitral leaflet, with a subaortic chordal attachment, resulting in a severe increase in LVOT gradient (118 mmHg).…”

Section: Discussionmentioning

confidence: 99%

A rare case of accessory mitral valve tissue causing left ventricular outflow tract obstruction associated with parachute mitral valve, ventricular septal defect, bicuspid aortic valve, unruptured aneurysm of aortic sinus: a case report

Wang

et al. 2018

European Heart Journal - Case Reports

View full text Add to dashboard Cite

Background Accessory mitral valve tissue rarely causes left ventricular outflow tract obstruction in adults. It is often associated with other cardiac and vascular congenital malformations. Here, we report the rarest presentation of accessory mitral valve tissue (AMVT) causing left ventricular outflow tract obstruction. Case summary A 22-year-old female patient presented with a history of shortness of breath and chest pain for more than 5 years. A diagnosis of AMVT with parachute mitral valve, ventricular septal defect (VSD), bicuspid aortic valve, unruptured aneurysm of aortic sinus, and left ventricular outflow tract obstruction was made. Successful closure of VSD with mitral valve replacement, excision of AMVT, and repair of the aortic sinus were performed. The post-operative course was uneventful, and an echocardiogram showed complete resection of the accessory mitral valve, no residual shunt and no left ventricular outflow gradient. Additionally, the peak gradient of rapid filling phase and atrial systolic phase across the prosthetic mitral valve were 16 mmHg and 4 mmHg, respectively. The peak velocity across left ventricular outflow tract was 1.4 m/s. Discussion Accessory mitral valve tissue is associated with other cardiac abnormalities and is usually diagnosed in the first or second decade of life. It is responsible for left ventricular outflow tract obstruction. The obstruction can occur in the early period of life due to continued deposition of fibrous tissues within left ventricular outflow tract. Accessory mitral valve tissue should be considered a rare but important cause of left ventricular outflow tract obstruction.

show abstract

Section: Discussionmentioning

confidence: 99%

A rare case of accessory mitral valve tissue causing left ventricular outflow tract obstruction associated with parachute mitral valve, ventricular septal defect, bicuspid aortic valve, unruptured aneurysm of aortic sinus: a case report

Wang

et al. 2018

European Heart Journal - Case Reports

View full text Add to dashboard Cite

show abstract

“…3 Severe obstruction can present with substantial cardiovascular compromise in infancy, whereas less severe obstruction can go undetected into adulthood and be identified after detection of a murmur or presentation with dyspnea, fatigue, palpitations, chest pain, or syncope. [3][4][5] Most cases of AMVT are associated with other cardiac abnormalities. Manganaro and colleagues 4 identified 104 patients who were diagnosed with AMVT from 1963 to 2012.…”

Section: Discussionmentioning

confidence: 99%

Accessory Mitral Valve Leaflet Causing Severe Left Ventricular Outflow Tract Obstruction in a Preterm Neonate with a Partial Atrioventricular Septal Defect

Wilkes¹,

Fraser²,

Seery³

2016

Texas Heart Institute Journal

View full text Add to dashboard Cite

A trioventricular septal defects (AVSDs) are characterized by deficiency of the atrioventricular (AV) septum, abnormalities of the AV valves, and a predisposition to progressive left ventricular outflow tract (LVOT) obstruction. This progressive obstruction is caused by an elongated "gooseneck" LVOT deformity that displaces the aortic valve anteriorly. Left ventricular outflow tract obstruction occurs most often when 2 distinct AV valve orifices are present, as in partial AVSD; and also in complete AVSD when the superior bridging leaflet attaches to the crest of the interventricular septum (creating 2 orifices and further elongating the LVOT). Abnormal left-AV-valve chordal attachments, septal hypertrophy, and abnormally oriented papillary muscles can further exacerbate subaortic narrowing.1 Accessory mitral valve tissue (AMVT), a rare congenital malformation, can result in LVOT obstruction and is associated with other congenital cardiac anomalies. Accessory mitral valve (MV) leaflet, the typical form of AMVT, has been reported only once before in association with AVSD. 2 We describe the case of a very small, premature neonate who underwent partial-AVSD repair and accessory MV (or left-AV-valve) leaflet resection to correct severe LVOT obstruction. Case ReportIn May 2014, a 6-day-old preterm male neonate was transferred to our institution from another hospital. The diagnosis was severe aortic stenosis. His mother's pregnancy was notable for dizygotic twins, well-controlled gestational diabetes mellitus, and delivery by cesarean section because of placenta previa and premature membrane rupture. The infant's birth weight of 1,790 g was appropriate for his estimated gestational age of 31 weeks. At birth, he needed continuous positive airway pressure support but overall appeared clinically well; however, a murmur prompted echocardiographic testing, the results of which raised concerns about severe aortic stenosis. His twin brother was concurrently diagnosed with a membranous ventricular septal defect. There was no other known family history of congenital heart disease.Prostaglandin E 1 therapy had been initiated before the infant's transport to our hospital. Physical examination revealed a nondysmorphic premature neonate. Auscultation yielded a gallop, a harsh grade 4/6 systolic murmur best heard along the mid right sternal border, and a palpable thrill across the sternum. A chest radiograph showed Case Reports

show abstract

“…Subvalvar aortic stenosis corresponds to about 1% of congenital heart diseases. A rare cause of this congenital condition is the obstruction by an accessory mitral valve tissue, approximately half of these corresponding to an accessory mitral leaflet [ 6 , 7 ]. Discrete subvalvar aortic stenosis represents a unique cardiac lesion.…”

Section: Introductionmentioning

confidence: 99%

Left Ventricle Outflow Obstruction by Reverse-Oriented Tricuspid Semilunar Valve-Like Endocardial Duplicatures

Babál

Kubíková

2018

Case Reports in Cardiology

View full text Add to dashboard Cite

A 57-year-old female had a history of hypertension disease, and one year before her death, her ECG showed signs of left ventricle hypertrophy. She died with signs of heart failure with pulmonary edema development. At autopsy, there was left ventricle hypertrophy (wall thickness: 21 mm). In the left ventricle outflow channel, 15 mm below the aortic valve on the muscular wall, there were three white 1–1.5 mm thick membranous semilunar valve-like structures with the sizes of 9, 7, and 5 mm, with concavities opened into the left ventricle, reducing the outflow area by 21.5%. These structures were hanging on the regular muscular ventricular wall, without any visible fibrous anchoring structure and without formation of commissures, and were composed of fine collagen and elastic fibers. Gross anatomy as well as histological structure was different from the subaortic membrane. The reported accessory reverse-oriented tricuspid semilunar valve-like structure is an unusual finding of a structure in the left ventricular outflow tract, to which we could not find an analogy in the available literature.

show abstract

Accessory mitral leaflet: an uncommon form of subaortic stenosis

Cited by 4 publications

References 5 publications

A rare case of accessory mitral valve tissue causing left ventricular outflow tract obstruction associated with parachute mitral valve, ventricular septal defect, bicuspid aortic valve, unruptured aneurysm of aortic sinus: a case report

A rare case of accessory mitral valve tissue causing left ventricular outflow tract obstruction associated with parachute mitral valve, ventricular septal defect, bicuspid aortic valve, unruptured aneurysm of aortic sinus: a case report

Accessory Mitral Valve Leaflet Causing Severe Left Ventricular Outflow Tract Obstruction in a Preterm Neonate with a Partial Atrioventricular Septal Defect

Left Ventricle Outflow Obstruction by Reverse-Oriented Tricuspid Semilunar Valve-Like Endocardial Duplicatures

Contact Info

Product

Resources

About