An isolated anterior mitral leaflet cleft: a case report

Abstract

IntroductionThe anterior mitral leaflet cleft is an unusual congenital lesion most often encountered in association with other congenital heart defects. The isolated anterior leaflet cleft is quite a rare anomaly and is usually cause of mitral valve regurgitation. The importance of the lesion is that it is often correctable. When feasible, cleft suture and, eventually, annuloplasty are preferable to valve replacement. Echocardiography is the first choice technique in the evaluation of mitral valve disease, providing useful information about valve anatomy and hemodynamic parameters.Case presentationWe present a case of an isolated anterior mitral leaflet cleft producing moderate-severe mitral regurgitation correctly identified by echocardiography and successfully surgically corrected.ConclusionIsolated cleft is a rare aberration, that has to be known in order to be diagnosed. Transthoracic and transesophageal echocardiography is the most useful non invasive technique for cleft diagnosis and to indicate the right surgical correction.

Biventricular noncompaction and mitral cleft

“…Frequently the anterior leaflet of the mitral valve is involved. It is caused by incomplete expression of endocardial cushion (6). In our case, mitral cleft was also present.…”

Isolated Case of a Slot in the Anterior Leaflet of the Mitral Valve Revealed by Mitral Insufficiency

“…The mitral cleft (MC) is defined as an orifice or a "defect" which is due to a lack of fusion of the endocardial buds. It is preferentially located on the anterior leaflet of the mitral valve and more rarely on the posterior leaflet [2]. First described in 1954 by Edwards et al, MC has an incidence of 0.07% in ultrasound series [1,3].…”

A rare case series of mitral valve clefts diagnosed by 3D echocardiography and mini‐review of the literature

“…Also, recent advances in transducer technology have permitted the acquisition of high-resolution images and abnormalities that were once only diagnosed during surgery are nowadays diagnosed before surgery, such is the case of clefts and cleft-like indentations in the leaflets. [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18] While the accuracy of three-dimensional echocardiography in the diagnosis of left atrioventricular valve leaflets anomalies has been established in several studies comparing the preoperative diagnosis and intra-operative findings, there is some pitfalls in three-dimensional echocardiography that should be minded when reporting gaps in valve leaflets such as echo dropouts (annular calcification, improper gain) or oblique imaging planes creating the impression of a fissure not actually present. 1,16,19…”