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Accessory Mitral Valve Leaflet
Accessory Mitral Valve Leaflet Ahmed El-Eshmawi, MD, Javier G. Castillo, MD, Amanda J. Rhee, MD, Amit Pawale, MD, and Anelechi C. Anyanwu, MD Department of Cardiac Surgery and Cardiac Anesthesia, Mount Sinai Medical Center, New York, New York
FEATURE ARTICLES Fig 1.
A
n 89-year-old-man with severe symptomatic aortic stenosis was found to have an accessory mitral valve leaflet causing systolic anterior motion on the preoperative echocardiogram. Intraoperative transesophageal echocardiography showed the presence of a 2-cm long and 0.4-cm thick membranelike structure (accessory mitral leaflet) attached to the ventricular side of the anterior mitral leaflet (Figs 1A-1C; Ao ¼ aorta, LA ¼ left
atrium, MV ¼ mitral valve). The accessory mitral leaflet projected into the left ventricular outflow tract during the peak of systole (Fig 1D). An aortic valve replacement with bioprosthetic valve was performed along with excision of the accessory mitral valve leaflet (Figs 1E, 1F) through the aortototomy. There was no mitral regurgitation or systolic anterior motion at the end of the procedure.
Address correspondence to Dr Anyanwu, 1190 Fifth Ave, Box 1028, New York, NY 10029; e-mail: [email protected].
Ó 2014 by The Society of Thoracic Surgeons Published by Elsevier Inc
Ann Thorac Surg 2014;98:344 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.03.053
FEATURE ARTICLES Fig 1.
A
n 89-year-old-man with severe symptomatic aortic stenosis was found to have an accessory mitral valve leaflet causing systolic anterior motion on the preoperative echocardiogram. Intraoperative transesophageal echocardiography showed the presence of a 2-cm long and 0.4-cm thick membranelike structure (accessory mitral leaflet) attached to the ventricular side of the anterior mitral leaflet (Figs 1A-1C; Ao ¼ aorta, LA ¼ left
atrium, MV ¼ mitral valve). The accessory mitral leaflet projected into the left ventricular outflow tract during the peak of systole (Fig 1D). An aortic valve replacement with bioprosthetic valve was performed along with excision of the accessory mitral valve leaflet (Figs 1E, 1F) through the aortototomy. There was no mitral regurgitation or systolic anterior motion at the end of the procedure.
Address correspondence to Dr Anyanwu, 1190 Fifth Ave, Box 1028, New York, NY 10029; e-mail: [email protected].
Ó 2014 by The Society of Thoracic Surgeons Published by Elsevier Inc
Ann Thorac Surg 2014;98:344 0003-4975/$36.00 http://dx.doi.org/10.1016/j.athoracsur.2014.03.053