Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in an adult Yoshikazu Aoka, MD, Naoko Ishizuka, MD, PhD, Yasunari.

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Presentation transcript:

Accessory mitral valve tissue causing severe left ventricular outflow tract obstruction in an adult Yoshikazu Aoka, MD, Naoko Ishizuka, MD, PhD, Yasunari Sakomura, MD, PhD, Hirotaka Nagashima, MD, PhD, Masatoshi Kawana, MD, PhD, Akihiko Kawai, MD, PhD, Hiroshi Kasanuki, MD, PhD The Annals of Thoracic Surgery Volume 77, Issue 2, Pages 713-715 (February 2004) DOI: 10.1016/S0003-4975(03)01217-7

Fig 1 Transesophageal echocardiographic (TEE) findings of an accessory mitral valve (AMV). (A, B) Preoperative TEE: (A) The arrow indicates AMV tissue protruding into the left ventricular outflow tract (LVOT). Note the marked concentric left ventricle (LV) hypertrophy. (AO = aorta; LA = left atrium.) (B) The mosaic flow pattern shows a pressure gradient across the LVOT produced by the AMV. (C, D) Postoperative TEE: (C) The abnormal tissue has been completely removed, (D) and no abnormal flow is seen in the LVOT. The Annals of Thoracic Surgery 2004 77, 713-715DOI: (10.1016/S0003-4975(03)01217-7)

Fig 2 Intraoperative findings and excised accessory mitral valve. (A) Extra chordae originating from the accessory mitral valve are seen between the tips of the forceps (right side). The operator is picking up the accessory valve using forceps with the left hand toward the left side of this photo. (B) Reproduction of the condition in which the accessory mitral valve protrudes into the left ventricular outflow tract by filling with water from the left ventricle. A parachute-like structure can be seen just below the aortic valve. (C) The white, membranous, and parachute-like accessory mitral valve after resection. The Annals of Thoracic Surgery 2004 77, 713-715DOI: (10.1016/S0003-4975(03)01217-7)