Severe mitral regurgitation due to anterior mitral leaflet perforation after surgical treatment of discrete subaortic stenosis

Abstract

Congenital subvalvular aortic stenosis may be associated with anomalies of the mitral valve. In this case, we present a patient with severe mitral valve regurgitation due to a perforation in the anterior mitral leaflet detected 4 months after an operation for relief of subaortic stenosis. A 10-year-old male patient who was operated for subvalvular aortic stenosis in another clinic was admitted to our hospital, and transthoracic echocardiography revealed severe mitral valve regurgitation due to a defect that was demonstrated at the anterior valve leaflet. The perforated area at the mitral valve zone A1 was repaired with a PTFE patch. The patient was successfully operated for the mitral valve perforation and the postoperative course was uneventful. In our case, the perforation in the anterior mitral leaflet implies a possible implementation of inappropriate surgical technique which necessitated a second surgical intervention after the initial operation.

Late perforation of anterior mitral leaflet after surgical resection of the subaortic membrane

“…Although mitral leaflet tears may be seen as an acute complication during surgical subaortic membrane resection [4], cases of anterior mitral leaflet perforation have been reported in the relatively late or late postoperative period after surgical resection of the subaortic membrane [5,6]. Ozyuksel et al reported a case similar to ours [5]. In this case, anterior mitral leaflet perforation and severe MR associated with the perforation had developed 4 months after the surgical treatment of discrete subaortic membrane.…”

“…Although mitral leaflet tears may be seen as an acute complication during surgical subaortic membrane resection [4], cases of anterior mitral leaflet perforation have been reported in the relatively late or late postoperative period after surgical resection of the subaortic membrane [5,6]. Ozyuksel et al reported a case similar to ours [5].…”

“…Primary pathology or degeneration of valvular tissue is other mechanistic cause of MLP other than IE [2,3]. MLP cases have been rarely reported during or subsequent to different surgical or interventional cardiac procedures that are relevant to mitral valve and left ventricular outflow tract (LVOT) [4][5][6][7][8][9][10].…”