Accessory Miniature Mitral Valve Causing Subaortic Obstruction

SummaryAccessory atrioventricular valvar tissue is uncommon and, on occasion, has been identified as a cause of ventricular outflow obstruction. Accessory tricuspid valvar tissue has been reported to cause subpulmonary obstruction but infrequently has accessory tissue arising from the mitral valve been associated with obstruction. This paper reports two cases of subvalvar obstruction; the first in association with a ventricular septal defect causing subaortic obstruction and the other in association with congenitally corrected transposition and a ventricular septal defect, causing subpulmonary obstruction.

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Noonan syndrome: Structural abnormalities of the mitral valve causing subaortic obstruction

European Journal of Pediatrics ◽

10.1007/bf01958636 ◽

1995 ◽

Vol 154 (12) ◽

pp. 949-952 ◽

Cited By ~ 28

Author(s):

B. Marino ◽

M. G. Gagliardi ◽

M. C. Digilio ◽

B. Polletta ◽

S. Grazioli ◽

...

Keyword(s):

Mitral Valve ◽

Noonan Syndrome ◽

Structural Abnormalities ◽

Subaortic Obstruction

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Accessory mitral valve without subaortic obstruction of left ventricular outflow tract in a middle-aged male

BMJ Case Reports ◽

10.1136/bcr-2012-006949 ◽

2012 ◽

Vol 2012 (nov21 1) ◽

pp. bcr2012006949-bcr2012006949 ◽

Cited By ~ 3

Author(s):

C. Golias ◽

T. Bitsis ◽

D. Krikidis ◽

K. Charalabopoulos

Keyword(s):

Mitral Valve ◽

Left Ventricular Outflow Tract ◽

Ventricular Outflow Tract ◽

Left Ventricular ◽

Outflow Tract ◽

Middle Aged ◽

Left Ventricular Outflow ◽

Subaortic Obstruction ◽

Middle Aged Male

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Double orifice mitral valve associated with subaortic stenosis—echocardiographic and anatomic findings

Cardiology in the Young ◽

10.1017/s1047951100002134 ◽

1994 ◽

Vol 4 (2) ◽

pp. 168-171

Author(s):

Thomas B. Johnson ◽

Derek A. Fyfe ◽

Stephen J. Swanger

Keyword(s):

Mitral Valve ◽

Congenital Heart ◽

Surgical Repair ◽

Subaortic Stenosis ◽

Complex Congenital Heart Disease ◽

Surgical Results ◽

Intraoperative Transesophageal Echocardiography ◽

Hemodynamic Function ◽

Subaortic Obstruction ◽

Double Orifice

SummaryWe describe an infant with complex congenital heart disease, including double orifice of the mitral valve associated with complex subaortic stenosis. Transthoracic and intraoperative transesophageal echocardiography were used to define three distinct anatomic abnormalities, all potentially contributing to the subaortic obstruction. Stepwise surgical repair with transesophageal echocardiographic monitoring of hemodynamic function ensured optimal initial surgical results. Overwhelming postoperative complications ensued, however, and the patient died. Postmortem findings are also presented.

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Dynamic subaortic obstruction: A disease of the mitral valve suitable for surgical repair?

Journal of the American College of Cardiology ◽

10.1016/0735-1097(96)00213-6 ◽

1996 ◽

Vol 28 (1) ◽

pp. 203-206 ◽

Cited By ~ 25

Author(s):

Ehud Schwammenthal ◽

Robert A. Levine

Keyword(s):

Mitral Valve ◽

Surgical Repair ◽

Subaortic Obstruction

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Reconstructive surgery of idiopathic hypertrophic cardiomyopathy, systolic anterior motion and severe mitral regurgitation

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0408254s ◽

2004 ◽

Vol 132 (7-8) ◽

pp. 254-257

Author(s):

Ivan Stojanovic ◽

Milan Vukovic ◽

Vojislava Neskovic ◽

Milan Babic ◽

Miroljub Zlatanovic ◽

...

Keyword(s):

Mitral Valve ◽

Mitral Annulus ◽

Subaortic Stenosis ◽

Mitral Insufficiency ◽

Systolic Anterior Motion ◽

Anterior Leaflet ◽

Septal Myectomy ◽

Long Time ◽

Subaortic Obstruction ◽

Idiopathic Disease

Hypertrophie obstructive cardiomyopathy (HOCM) is an idiopathic disease frequently associated with systolic anterior motion (SAM). The anterior leaflet of mitral valve is sucked by Ventury effect into the left ventricle outflow tract making subaortic stenosis more severe and producing mitral insufficiency at the same time. Septal myectomy along with mitral valve replacement has been the treatment of choice for a long time. An understanding of pathoanatomy and hemodynamics of the disease has opened possibility for total reconstructive treatment of both subaortic stenosis and mitral insufficiency in such patients. This is a case report of 50-year-old male with severe subaortic stenosis (136/70 mmHg) due to HOCM and SAM along with grade IV mitral insufficiency. Septal myectomy was performed. Mitral insufficiency was managed by reducing the height of posterior cusp along with remodeling of mitral annulus by Carpentier-Classic ring. In that way, subaortic obstruction was reduced to 30.9/10 mmHg while mitral insufficiency was lowered to negligible level. The patient was discharged from hospital with sinus rhythm eight days after the surgery.

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