A Band That Causes Leaky Valves: Severe Mitral Regurgitation due to Left Atrial Fibrous Band—A Case Report and Literature Review

Nnaoma, Christopher; Sandhu, Gurdarshan S.; Sossou, Christoph; Vavilin, Ilan; Bustillo, José; Garg, Anshu

doi:10.1155/2019/2458569

Cited by 3 publications

(4 citation statements)

References 8 publications

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“…Since then a total of 18 cases of LABs have been described in vivo. 4,[6][7][8][9] In all cases, the LABs originated from the inter-atrial septum, and attached to a MV leaflet in 50% of cases, other LA walls in 39% of cases and a pulmonary vein in 11% of cases. Those attached to the left atrial walls were largely incidental findings, whereas those with MV involvement mainly caused mitral regurgitation, with the exception of one case which led to mitral stenosis.…”

Section: Discussionmentioning

confidence: 99%

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Mitral annular fibrous band—a unique morphological variant of a rare congenital mitral valve anomaly: a case report

Okafor

Vamvakidou

Lyon

et al. 2022

European Heart Journal - Case Reports

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Background Left atrial bands are rare and can be associated with mitral valve dysfunction, heart failure and stroke. Most cases are identified on autopsy and the demonstration in vivo is very uncommon. Various anatomical configurations have been reported. This description of a mitral annular fibrous band contributes to the literature as the first reported case to traverse the supravalvular mitral inflow region, without involving the left atrium. Case Summary A 59-year-old man with a history of metastatic duodenal carcinoma was admitted with a two-week history of fever and rigors. Inflammatory markers were elevated and blood cultures positive for Enterococcus feacium. Transoesophageal echocardiography performed to investigate for infective endocarditis revealed a 2.3 cm long, thin fibrous band attached to the posterior mitral annulus and extending to the base of the middle scallop of the anterior mitral valve leaflet causing localized tethering, but no valve dysfunction. The band was felt to represent a bystander anatomic variant unrelated to the sepsis, which was most likely gastrointestinal in origin. The patient responded well to intravenous antibiotics. Conclusions The presence of an abnormal intracardiac structure in the setting of occult infection should always raise the suspicion of infective endocarditis. Using detailed 2D multiplanar and 3D transoesophageal echocardiography, we were able to identify the anomalous band and exclude any overt infective vegetations attached to the band or the leaflets. Once identified, treatment options range from conservative management to surgical resection and mitral valve surgery if concomitant valvular dysfunction is demonstrated.

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Section: Discussionmentioning

confidence: 99%

“…However, in some cases, LABs may extend from the inter-atrial septum and attach to a mitral valve (MV) leaflet or pulmonary vein, and this may lead to MV dysfunction, heart failure or atrial arrhythmias. 4 In rare cases, LABs have also been associated with cryptogenic stroke.…”

Section: Introductionmentioning

confidence: 99%

Mitral annular fibrous band—a unique morphological variant of a rare congenital mitral valve anomaly: a case report

Okafor

Vamvakidou

Lyon

et al. 2022

European Heart Journal - Case Reports

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“…대부분 무증상이지만 승모판 역류(mitral regurgitation) 및 심방세동과의 연관성도 보고되고 있다. 영상에서 좌심방띠는 삼심방증(cor triatriatum)으로 오인될 수 있어 판독에 주의를 요하며, 심도자술 시 카테터 진행을 방해할 수 있어 시술 전 영상 검사에서 해당 변이의 위치를 파악하여 판독문에 기재해주어야 한다( 45 ).…”

Section: 정상 변이와 해석상의 함정들unclassified

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology

송

김

구

et al. 2020

J Korean Soc Radiol

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Current advances in CT techniques allow thorough evaluation of the beating heart. The strengths of cardiac CT relative to echocardiography and magnetic resonance imaging are its high availability in most institutions, rapid production of high-quality images, and outstanding delineation of the anatomy. For many normal variants and pathologic conditions, such as thrombi, masses, and congenital abnormalities of the left atrium, CT findings are sufficient to make a presumptive diagnosis. Assessments of the left atrium and left atrial appendage are particularly important for the management of atrial fibrillation, as various catheter-based procedures are aimed at the mechanical and electrical isolation of these structures. CT offers information crucial to a successful catheter-based procedure or surgery. Therefore, a comprehensive review of the geometry (shape, size, and relative position), along with various CT imaging features of pathologic states, should be provided in radiology reports to be of clinical value.

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“…In addition, it has been related to atrial fibrillation, stroke, or mitral valve disease, although a definite association with mitral regurgitation has not yet been established 2 2 or accessory mitral valve tissue, 3 which have different clinical implications.…”

Section: Introductionmentioning

confidence: 99%

Accessory left atrial cords: A case report and literature review

Aranda-Domene

Minano-Frutos

Arribas-Leal

et al. 2022

Journal of Cardiac Surgery

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Introduction: Accessory left atrial cords are fibroelastic structures found in the left atrium. Left atrial cords may be associated with mitral valve disease, atrial fibrillation, stroke, and other congenital left-side anomalies. Methods: We presented the case of a man with severe Mitral Regurgitation and two accessories left atrial cords attached to P2 scallop by a single tendon and performed a literature review using PUBMED/MEDLINE, Web of Science, and EMBASE databases on December 4, 2021.Results: According to our review, accessory left atrial cords were found more frequently in women (36 patients, 62%), more frequently attached to the mitral valve (66% of reports) and mitral regurgitation was the most frequently reported pattern of mitral valve disease (64.2%). No other cases of double left atrial cords attached to P2 segment were found. Conclusion:Accessory left atrial chords may be related to mitral valve disease and other left-side congenital abnormalities. These structures were found more frequently in females and A2 insertion was the most frequently observed pattern in the review.

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A Band That Causes Leaky Valves: Severe Mitral Regurgitation due to Left Atrial Fibrous Band—A Case Report and Literature Review

Cited by 3 publications

References 8 publications

Mitral annular fibrous band—a unique morphological variant of a rare congenital mitral valve anomaly: a case report

Mitral annular fibrous band—a unique morphological variant of a rare congenital mitral valve anomaly: a case report

Computed Tomography of the Left Atrium and Left Atrial Appendage: A Pictorial Essay on the Anatomy, Normal Variants, and Pathology

Accessory left atrial cords: A case report and literature review

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