Isolated accessory mitral valve tissue in an asymptomatic elderly patient
- PDF / 249,763 Bytes
- 3 Pages / 595.276 x 790.866 pts Page_size
- 36 Downloads / 191 Views
CASE REPORT
Isolated accessory mitral valve tissue in an asymptomatic elderly patient Toshimitsu Tsugu • Shiro Iwanaga • Kenichi Matsushita • Hikaru Tsuruta • Makiko Dan • Mitsushige Murata • Keiichi Fukuda
Received: 27 August 2012 / Revised: 14 March 2013 / Accepted: 26 March 2013 Ó Japanese Society of Echocardiography 2013
Abstract Accessory mitral valve tissue is a membranous or tumor-like structure observed in the left ventricular outflow tract. This congenital anomaly has been reported in more than 100 cases since 1842; however, most of them were found in patients with complex cardiac malformations. We report a 72-year-old Asian woman with isolated accessory mitral valve tissue incidentally found during the evaluation of hypertension and arrhythmia. Her left ventricular outflow tract obstruction was mild. Because worsening of the left ventricular outflow tract obstruction was reported in patients without significant obstruction at the time of diagnosis, periodical echocardiographic follow-up is necessary.
T. Tsugu H. Tsuruta M. Dan K. Fukuda Cardiology Division, Department of Medicine, Keio University School of Medicine, Tokyo, Japan S. Iwanaga (&) Department of Cardiology, Tokyo Medical University and Hachioji Medical Center, 1163 Tatemachi, Hachioji, Tokyo 193-0998, Japan e-mail: [email protected] K. Matsushita Department of Cardiology, Kyorin University School of Medicine, Tokyo, Japan M. Murata Department of Laboratory Medicine, Keio University School of Medicine, Tokyo, Japan
Keywords Echocardiography Congenital heart disease Left ventricular outflow tract obstruction Mitral valve anomaly
Case report A 72-year-old Asian woman without significant medical history visited our hospital because of hypertension and arrhythmia. Echocardiographic evaluation revealed an abnormal membranous structure in the left ventricular outflow tract (LVOT) (Figs. 1 and 2). The abnormal structure looked like an unfolded parachute during systole and attached to the endocardium of the basal anterior wall. Any morphological and functional abnormality was not observed in the mitral valve nor in the aortic valve. The abnormal tissue was similar to a mitral valve leaflet, therefore, we diagnosed it as an accessory mitral valve tissue. She did not have any symptoms including dyspnea, chest pain, or syncope. There was no abnormality in her electrocardiogram. The LV size and function was normal. Pressure gradient across the LVOT was 13 mmHg by the continuous Doppler method. Accessory mitral valve tissue was first reported by Chevers [1], and the first surgical resection was performed by MacLean et al. [2]. It is a rare congenital malformation that is commonly associated with other congenital cardiac malformations. Most of them are diagnosed by the age of 10 years (mean age, 6.5) after developing syncope or symptoms from left ventricular failure. The abnormality was confirmed in approximately 100 patients; however, there were only 15 adult cases within them. Rovner et al. performed echocardiography in 130,000 cas
Data Loading...
