Independent factors associated with outcomes of parachute mitral valve in 84 patients

Schaverien, Mark V.; Freedom, R. M.; McCrindle, Brian W.

doi:10.1016/j.accreview.2004.07.081

Cited by 13 publications

(24 citation statements)

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“…Most patients are diagnosed in childhood with the pathologic complex known as Shone's Anomaly, which includes a PMV, aortic coarctation, atrial septal defect, ventricular septal defect, aortic valve stenosis, subaortic stenosis, and left ventricular hypoplasia. 4) As in this case, elderly patient of the isolated single papillary muscle without other cardiac anomaly and presenting with mitral valve regurgitation is extremely rare. Marino et al also reported that most patients with PMV did not have mitral valve regurgitation at initial echocardiogram, and only a small number of patients had progression to hemodynamically significant mitral valve regurgitation.…”

Section: Discussionmentioning

confidence: 74%

Successful Surgical Repair of the Parachute Mitral Valve with Mitral Valve Regurgitation

Shiraishi

Yamaguchi

Adachi

2012

ATCS

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A 65-year-old woman with exercise-related dyspnea was admitted to our hospital. Transthoracic echocardiography demonstrated a large anomalous papillary muscle that originated from the posterior wall of the left ventricle and severe mitral valve regurgitation in systole. Cleft suture, 5-0 polytetrafluoroethylene sutures from a single papillary muscle to the anterior commissure leaflet (AC), 5-0 polypropylene sutures between AC and A1, and between A1 and A2, the double-orifice technique, and ring plasty with 32-mm semi-rigid ring was performed. Postoperative echocardiography showed an improvement in severe mitral valve regurgitation. At the 2-month follow-up, the patient was in good health. In the present case, the elderly patient with an isolated parachute mitral valve but without any other cardiac anomaly and presenting with mitral valve regurgitation is extremely rare. This case of mitral valvuloplasty for a parachute mitral valve with a single papillary muscle in an elderly woman has not been reported before.Keywords: parachute mitral valve, single papillary muscle, mitral valve regurgitation, mitral valve plasty Case ReportA 65-year-old woman who had exercise-related dyspnea was admitted to our hospital for evaluation. She had been asymptomatic before presentation. On physical examination, there was a grade 4/6 holosystolic regurgitant murmur audible throughout the precordium. The peripheral pulses were normal, and the rest of her examination was unremarkable. Anteroposterior chest X-ray demonstrated no cardiomegaly showed a sinus rhythm with a rate of 66/min, and complete right bundle branch block. A two-dimensional and color Doppler echocardiogram was performed. It demonstrated a large anomalous papillary muscle that originated from the posterior wall of the left ventricle with a dilated left atrium and left ventricle, and a cleft in the posterior leaflet of the mitral valve (Fig. 1a). Color Doppler showed severe mitral valve regurgitation in systole (Fig. 1b). Pulse-Doppler recording of transmitral flow from the left ventricle apex demonstrated no features of mitral valve stenosis (Fig. 1c). Cardiac catheterization was performed which confirmed the diagnosis and demonstrated hyperkinetic pulmonary artery

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Section: Discussionmentioning

confidence: 74%

Successful Surgical Repair of the Parachute Mitral Valve with Mitral Valve Regurgitation

Shiraishi

Yamaguchi

Adachi

2012

ATCS

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“…Using first-pass perfusion MRI allows to differentiate the enhancing myocardium from poorly vascularised and therefore hypoenhancing fibroma. In contrast, true parachute mitral valve is characterised by a single or fused papillary muscle [10] and shows no different first-pass enhancement pattern (Fig. 4).…”

Section: Discussionmentioning

confidence: 87%

First experiences with contrast-enhanced first-pass MR perfusion imaging in patients with primary, benign cardiac masses and tumour-like lesions

et al. 2008

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The aim of this study was to evaluate the diagnostic value of contrast-enhanced first-pass perfusion MRI in patients with suspected cardiac masses and tumour-like lesions. Twenty patients underwent contrast-enhanced first-pass saturation-recovery steady-state-free-precession perfusion MRI in addition to clinical MRI. Eleven diagnostic parameters were analysed blinded in consensus by three observers: localisation (paracardiac/mural/intracavitary), malignancy (benign/malignant) and first-pass enhancement pattern (homogeneous/heterogeneous as well as non-perfused/hypoperfused/iso-perfused/ hyperperfused). The results were compared to combined references comprising histology, cytology, medical and surgical reports, echocardiography, chest X-ray, coronary angiography and regular MRI. Also, we analysed if additional first-pass perfusion confirmed, changed or reduced the number of differential diagnoses compared to clinical MRI. All cardiac masses or tumour-like lesions were correctly localised and scored as benign lesions. For homogeneous perfused lesions the sensitivity, specificity, positive and negative predictive value was 94/100/100/67%, 100/94/67/100% for heterogeneous perfused lesions, 92/100/100/88% for non-perfused, 100/94/75/100 for hypoperfused, 100/100/100/100% for hyperperfused and for isoperfused lesions. In 17/2/1 cases perfusion MRI confirmed, reduced or increased the number of potential differentials. First-pass perfusion MRI provides valuable information in patients with benign cardiac masses or tumour-like lesions. Further experience is needed to underline these preliminary observations.

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“…Most patients with Shone's Anomaly are diagnosed in childhood. The complex includes a parachute mitral valve and aortic coarctation (68 % of patients), atrial septal defect (54 % of patients), ventricular septal defect (46 % of patients), aortic valve stenosis (32 % of patients), subaortic stenosis (20 % of patients), and left ventricular hypoplasia (19 % of patients) [ 3 ]. The primary morphological feature of parachute mitral valve is the unifocal attachment of chordae tendineae.…”

Section: Learning Pointsmentioning

confidence: 99%

“…Survival for patients with parachute mitral valve is dependent on the spectrum of associated cardiac lesions (left ventricular hypoplasia and atrial septal defect). The degree of mitral valve obstruction remains stable, and most patients do not require valvotomy [ 3 ].…”

Section: Learning Pointsmentioning

confidence: 99%

Congenital Mitral Valve Diseases

Yingchoncharoen

2015

An Atlas of Mitral Valve Imaging

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A 66-year-old woman has a history of coronary artery bypass grafting in 1987, when she had left main stenosis and underwent bypass with anastomosis of the left internal mammary artery to the left anterior descending artery and a saphenous vein graft to the obtuse marginal branch. The patient now returns with symptoms of congestive heart failure. She is found to have an atrioventricular canal defect including mitral valve regurgitation with mitral valve cleft, primum atrial septal defect, and severe tricuspid regurgitation. She also has a left-sided superior vena cava, into which she has an anomalous left upper pulmonary vein. She has recently noticed a signifi cant decline and can now walk only half a block at a slow pace before having to stop. She was referred to our institute for surgical correction of her complex congenital heart disease (Figs. 9.1 , 9.2 , 9.3 , 9.4 , 9.5 , 9.6 , 9.7 , 9.8 , 9.9 , and 9.10 ). ing showed atrial septal defect with left-to-right shunt at the level close to the cardiac crux, consistent with primum atrial septal defect. Also seen are mitral and tricuspid regurgitation (AVI 2320 kb) Video 9.8 Transesophageal echocardiography (TEE) fourchamber view showed primum atrial septal defect (AVI 6583 kb) Video 9.9 TEE short axis view at aortic valve level showed bicuspid aortic valve (AVI 6459 kb) Video 9.10 3D TEE of mitral valve (surgical view) showed anterior mitral valve cleft (AVI 218 kb)

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Independent factors associated with outcomes of parachute mitral valve in 84 patients

Cited by 13 publications

References 0 publications

Successful Surgical Repair of the Parachute Mitral Valve with Mitral Valve Regurgitation

Successful Surgical Repair of the Parachute Mitral Valve with Mitral Valve Regurgitation

First experiences with contrast-enhanced first-pass MR perfusion imaging in patients with primary, benign cardiac masses and tumour-like lesions

Congenital Mitral Valve Diseases

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