A Case of Cleft Mitral Valve Associated with Papillary Muscle Abnormality in an Adult

(Department of Cardiovascular Surgery, Kimitsu Central Hospital, Kisarazu, Japan and Department of Cardiovascular Surgery, Narita Red Cross Hospital*, Narita, Japan)

Hiroshi Iida* Yoshio Sudo Hideo Ukita
Isolated cleft of the anterior mitral leaflet in the presence of an intact atrioventricular septum is a rare cause of mitral regurgitation. We report a surgical case with cleft of the anterior mitral leaflet and abnormality of papillary muscles. A 53-year-old man was admitted to our hospital because of congestive heart failure. Echocardiography showed severe mitral regurgitation, severe tricuspid regurgitation, abnormal direct connection of the anterolateral papillary muscle and the anterior mitral leaflet and adhesion of the base of papillary muscles. At the posterior portion of the anterior leaflet, a 1-cm cleft was found during surgery. The top of the anterolateral papillary muscle adhered to the anterior leaflet, but rheumatic changes were not noted. The cleft was sutured directly, and annuloplasty was performed with a 31-mm Duran flexible ring. Tricuspid annuloplasty was also performed with the DeVega method. His postoperative course was not eventful. Mitral regurgitation caused by mitral cleft associated with abnormal connection of papillary muscles and the mitral leaflet have not been previously reported.
@Jpn. J. Cardiovasc. Surg. 36: 55-57 (2007)