‘Tri-leaflet mitral valve morphology’: a new phenotypic expression in hypertrophic cardiomyopathy?

Trileaflet Mitral Valve in the Setting of Hypertrophic Cardiomyopathy: A Curious Rarity With a Possible Association

“…2 Although there may be a possible genetic association between trileaflet mitral valves and hypertrophic cardiomyopathy, the uniqueness of this valvular defect makes it difficult for this association to be elucidated. 3,4 Our patient’s case supports the association of these two conditions and will contribute to the modest amount of literature that is currently available on trileaflet mitral valves.…”

A rare case of quadrileaflet mitral valve and ostium primum atrial septal defect

“…Failure of fusion of the leaflets derived from the superior and inferior cushions can result in clefting of the aortic leaflet subsequent to otherwise normal development; it is the latter arrangement that results in the trifoliate left component of the common valve found in the setting of AVSDs 4 . Trileaflet mitral valves have only been recently reported in the literature as an extremely rare distinct disease entity 5,6 . There are 6 published reports of 7 patients with trileaflet mitral valves, all of which were diagnosed by 3D echocardiography 7 …”

Case of trileaflet mitral valve: an important differential for non-classical intracavitary gradient in suspected hypertrophic cardiomyopathy

“…Although an association between HCM and trileaflet mitral valves has been described previously, in this case, the early diagnosis of HCM that later did not demonstrate progression of LV hypertrophy or increase in outflow gradient over 16 years was clearly a mischaracterisation of concurrent hypertensive cardiomyopathy with a complex, eccentric MR jet caused by the trileaflet mitral valve that was able to mascaraed as LV outflow obstruction on continuous wave Doppler(figures 1 and 7). 1 3–6 Interestingly, the patient’s first echocardiogram in 2002 was reported as an unusually significant LV outflow gradient given the minimal degree of LV hypertrophy. It is therefore important in cases of suspected HCM where there is a very high left ventricular outflow gradient in the presence of an eccentric MR jet that clinicians consider a differential diagnosis of a trileaflet mitral valve.…”

“…Although exceedingly rare, improvements in cardiac imaging technologies have led to the increasing characterisation of these congenital phenomena with now nine cases published globally to date 2. Of these cases, half describe an association with hypertrophic cardiomyopathy (HCM) 1 3–6. Only Guerreiro et al 7 address the prognostic implication of having trileaflet mitral valve by describing valve function over 10 years with deterioration to severe mitral regurgitation (MR).…”