Mitral insufficiency due to an isolated anterior-leaflet cleft: correction with an autologous pericardial patch supported by artificial chordae

Tex Heart Inst J. 2011;38(3):243-5.

Abstract

Congenital clefts of the mitral valve without an associated atrioventricular canal defect are rare, and they may cause mitral insufficiency that requires surgical correction. Repair is typically by direct suture; however, if the cleft is especially wide, the use of this technique may distort the valve leaflet and cause poor coaptation with valvular insufficiency.Herein, we present the case of a 39-year-old woman who had severe mitral valve insufficiency secondary to a wide isolated cleft of the anterior mitral leaflet. The valve was reconstructed with an autologous pericardial patch supported by polytetrafluoroethylene neochordae and an implanted annuloplasty ring. Echocardiographic examination 1 year postoperatively showed excellent competence of the mitral valve and good coaptation of the leaflets. To our knowledge, this is the 1st report that describes the use of artificial neochordae to support an autologous pericardial patch in the repair of a cleft in the anterior mitral valve leaflet.

Keywords: Adult; cardiac surgical procedures; echocardiography; heart defects, congenital/complications/surgery; mitral valve insufficiency/etiology/surgery; mitral valve/abnormalities/pathology/surgery; surgical techniques; treatment outcome.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Echocardiography, Doppler, Color
  • Echocardiography, Three-Dimensional
  • Echocardiography, Transesophageal
  • Female
  • Heart Defects, Congenital / complications
  • Heart Defects, Congenital / diagnostic imaging
  • Heart Defects, Congenital / surgery*
  • Heart Valve Prosthesis Implantation / instrumentation*
  • Heart Valve Prosthesis*
  • Humans
  • Mitral Valve / abnormalities
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery*
  • Mitral Valve Annuloplasty / instrumentation*
  • Mitral Valve Insufficiency / diagnostic imaging
  • Mitral Valve Insufficiency / etiology
  • Mitral Valve Insufficiency / surgery*
  • Pericardium / transplantation*
  • Prosthesis Design
  • Severity of Illness Index
  • Suture Techniques
  • Transplantation, Autologous
  • Treatment Outcome