Functional systolic anterior motion of the mitral valve due to accessory chordae
| Autor: | Simone Massaccesi, Salvatore Catania, Christopher Munch, Gianfranco Iacobone, Gian Piero Piccoli, Gigliola Mancinelli |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Aortic valve
medicine.medical_specialty Hemodynamics Ventricular outflow tract obstruction Transoesophageal echocardiography Ventricular Outflow Obstruction Diagnosis Differential Mitral valve Internal medicine medicine.artery Ascending aorta Humans Medicine cardiovascular diseases Aged Mitral regurgitation business.industry Mitral Valve Insufficiency General Medicine medicine.anatomical_structure cardiovascular system Cardiology Chordae Tendineae Mitral Valve Female medicine.symptom Tomography X-Ray Computed Cardiology and Cardiovascular Medicine business Medical therapy Echocardiography Transesophageal |
| Zdroj: | Journal of Cardiovascular Medicine. 9:105-108 |
| ISSN: | 1558-2027 |
| DOI: | 10.2459/jcm.0b013e3280c852b2 |
| Popis: | Accessory mitral valve tissue is an uncommon finding, usually associated with other congenital cardiac malformations and diagnosed during childhood. We present the case of a 70-year-old patient referred to our hospital for aortic valve and ascending aorta replacement. At preoperative examination, no evidence of mitral valve structural abnormalities was detected. Anaesthesia induction was complicated by sudden haemodynamic impairment. Intraoperative transoesophageal echocardiography showed two anomalous mitral chordae. The presence of abnormal mitral tissue also allowed to assess the mechanism of unexpected haemodynamic worsening: anomalous chordae caused anterior displacement of the anterior mitral leaflet, resulting in left ventricular outflow tract obstruction and mitral regurgitation. Medical therapy was instituted and the planned surgical approach was modified according to the new anatomy observed at echocardiographic examination. A valve-sparing technique was successfully applied. This case provides a good example of the diagnostic usefulness of routine intraoperative transoesophageal echocardiography, especially when facing unexpected findings. It also shows how transoesophageal echocardiography may help guide medical and surgical treatment. |
| Databáze: | OpenAIRE |
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