Partial Hammock Valve: Surgical Repair and Long-Term Follow-Up in 23 Patients

Undifferentiated Chordae Tendineae of the Mitral Valve: Large Cohort Study of a Rare Mitral Malformation

“…Another notable anatomic feature of UCMV is that the ALCT was entirely associated with un-differentiation, and no isolated PMCT was found, possibly because the attenuation and lengthening of the PMCT is completed earlier than that of the ALCT. The reported mitral hemi-arcade and partial hammock MV showed the same anatomical features ( 19 , 20 ). The anatomy of class I of UCMV and that of the parachute-like asymmetric MV proposed by Oosthoek ( 23 ) are extremely similar.…”

“…It is important to distinguish the separate muscular chordae of some normal MV from UCMV (26), which have fully developed chordae. ALCT dysplasia in class I is more common in children than previously reported, and many patients do not develop noticeable mitral insufficiency during childhood, and remain undiagnosed until they reach adulthood (19)(20)(21). In some patients of our cohort, ≥ moderate to severe MR during childhood was related to comorbid defects leading to increased left ventricular preload (Table 2).…”

“…However, some of our cases did not fit the classic mitral arcade pattern but comprised incomplete forms and appeared in a spectrum of undifferentiated chordae tendineae. Some mitral hemi-arcade and partial hammock MV have been reported in recent years (19,20), and some reported adult cases (21)(22)(23)(24)(25) support these findings. Accordingly, we proposed the concept of a spectrum of UCMV and classified it into three grades according to the involved chorda groups and presence or absence of MS.…”

“…There has been limited research on the diagnosis of mitral arcade using echo or surgery since Layman proposed it in 1967 ( 15 ). Historically, key terms related to it were proposed, such as hammock MV ( 16 ), congenital typical MS ( 6 , 17 , 18 ), mitral hemi-arcade ( 19 ), and partial hammock MV ( 20 ). Each term described one subtype of undifferentiated chordae tendineae.…”

Challenges of managing anomalous mitral arcade with severe mitral regurgitation and hydrops fetalis in infants

“…To achieve a more detailed assessment, the incorporation of three-dimensional echocardiography and cardiac MRI could be considered as additional options during infancy. 9 Recent studies have highlighted the potential benefits of combining three-dimensional transoesophageal echocardiography with multidetector CT, which can enhance spatial resolution and facilitate arcade reconstruction. This approach enables a more precise diagnosis and improved guidance for surgical management in adults.…”