Abstract:Background-Parachute mitral valve (PMV) is defined as a unifocal attachment of the mitral valve chordae to a single or dominant papillary muscle and may cause subvalvar obstruction. We sought to determine factors associated with outcomes. Methods and Results-Patients (nϭ84; 64% male) who presented between 1977 and 2001 at a median age of 3 days (range, birth to 5.4 years) were assessed with PMV (without atrioventricular septal defect). Associated cardiac anomalies in 99% included aortic coarctation in 68%, atr… Show more
“… 2 Although, extensive hemodynamic effects lead to diagnosis almost during infancy and childhood and remaining undiagnosed till adulthood is very uncommon, however a number of incomplete forms have been detected in adult patients. 3 , 4 Adults with PMV experience modest defects that do not need for echocardiography and may lead to under diagnosis of the anomaly.…”
A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV) cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis. No other congenital heart anomalies were identified. Thus, the final diagnosis was isolated parachute mitral valve (IPMV). She was one of the very rare IPMV cases have ever been reported in adults
“… 2 Although, extensive hemodynamic effects lead to diagnosis almost during infancy and childhood and remaining undiagnosed till adulthood is very uncommon, however a number of incomplete forms have been detected in adult patients. 3 , 4 Adults with PMV experience modest defects that do not need for echocardiography and may lead to under diagnosis of the anomaly.…”
A 29-year old female patient was referred to our hospital for evaluation of dyspnea NYHA class I which begun from several months ago. The only abnormal sign found on physical examination was a grade 2/6 systolic murmur at the apex position without radiation. Echocardiography revealed normal left and right ventricular sizes and systolic function, and only one papillary muscle in left ventricular (LV) cavity which all chordae tendineae inserted into that muscle. The mitral valve orifice was eccentrically located at the lateral side with mild to moderate mitral regurgitation but without significant mitral stenosis. No other congenital heart anomalies were identified. Thus, the final diagnosis was isolated parachute mitral valve (IPMV). She was one of the very rare IPMV cases have ever been reported in adults
“…Figures 2 A, B and Video 3 show the defining features of the parachute mitral valve, namely insertion of the chordae tendinae from the medial and lateral aspects of the mitral valve into a single papillary muscle ( 1 , 18 ). Stenosis is the common functional outcome, due to a variable combination of underdeveloped chordae limiting leaflet movement, along with significantly reduced interchordal spaces limiting secondary orifice function ( 18 , 19 , 20 , 21 ). This lesion is usually found in association with other anatomical abnormalities representing multilevel left heart obstruction ( 6 , 18 , 20 ).…”
“…Stenosis is the common functional outcome, due to a variable combination of underdeveloped chordae limiting leaflet movement, along with significantly reduced interchordal spaces limiting secondary orifice function ( 18 , 19 , 20 , 21 ). This lesion is usually found in association with other anatomical abnormalities representing multilevel left heart obstruction ( 6 , 18 , 20 ). Figure 2 (A) The cropping orientation which is used to visualise the chordal support of the mitral valve.…”
Congenital abnormalities of the left atrioventricular (AV) valve are a significant diagnostic challenge. Traditionally, reliance has been placed on two-dimensional echocardiographic (2DE) imaging to guide recognition of the specific morphological features. Real-time 3DE can provide unique views of the left AV valve with the potential to improve understanding of valve morphology and function to facilitate surgical planning. This review illustrates the features of congenital abnormalities of the left AV valve assessed by 3DE. The similarities and differences in morphology between different lesions are described, both with respect to the valve itself and supporting chordal apparatus. The potential advantages as well as limitations of this technique in clinical practice are outlined.
“…tendinae from the medial and lateral aspects of the mitral valve into a single papillary muscle (1,18). Stenosis is the common functional outcome, due to a variable combination of underdeveloped chordae limiting leaflet movement, along with significantly reduced interchordal spaces limiting secondary orifice function (18,19,20,21). This lesion is usually found in association with other anatomical abnormalities representing multilevel left heart obstruction (6,18,20).…”
Congenital abnormalities of the left atrioventricular (AV) valve are a significant diagnostic challenge. Traditionally, reliance has been placed on two-dimensional echocardiographic (2DE) imaging to guide recognition of the specific morphological features. Real-time 3DE can provide unique views of the left AV valve with the potential to improve understanding of valve morphology and function to facilitate surgical planning. This review illustrates the features of congenital abnormalities of the left AV valve assessed by 3DE. The similarities and differences in morphology between different lesions are described, both with respect to the valve itself and supporting chordal apparatus. The potential advantages as well as limitations of this technique in clinical practice are outlined. Key Words " mitral valve " left atrioventricular valve " three-dimensional echocardiography " congenital heart disease " atrioventricular septal defect " congenital mitral valve lesions Institutional practice and methods of acquisition This study was undertaken at the Evelina London Children's Hospital, a designated tertiary referral centre for congenital heart disease. RT3DE is used in all cases before surgical repair of an AV valve. The choice of transthoracic vs transoesophageal RT3DE was determined by the adequacy of transthoracic acoustic windows and the adequate size of the patient to accommodate a RT3DE transoesophageal echocardiography probe (R25 kg). This review uses an anonymised selection of images,
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