Mitral insufficiency with a double-orifice mitral valve in an adult patient Stefano Congiu, MD, Miguel Josa, MD, Xavier Freixa, MD, Manuel Azqueta, MD,

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Mitral insufficiency with a double-orifice mitral valve in an adult patient Stefano Congiu, MD, Miguel Josa, MD, Xavier Freixa, MD, Manuel Azqueta, MD, Carlos Mestres, MD, PhD, Jaime Mulet, MD, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 134, Issue 1, Pages 250-251 (July 2007) DOI: 10.1016/j.jtcvs.2006.11.074 Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Transesophageal echocardiography showed a severe prolapse of the posterior leaflet of the posteromedial orifice and a well-defined bridge with its own subvalvular apparatus that divided the mitral valve into a double-orifice structure. PV, posterior valve; AV, anterior valve; R, rafe (bridge); PO, posterior orifice; AO, anterior orifice. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 250-251DOI: (10.1016/j.jtcvs.2006.11.074) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Intraoperative view of the mitral valve showing two different mitral orifices separated by a tissue bridge. The larger orifice (right) was posteromedial and the smaller (left) was anterolateral. After valve resection, we could see a reconstruction of the two mitral orifices with a big tissue bridge supported and attached by its own chordae tendineae. OP, posterior orifice; R, rafe (bridge); OA, anterior orifice. The Journal of Thoracic and Cardiovascular Surgery 2007 134, 250-251DOI: (10.1016/j.jtcvs.2006.11.074) Copyright © 2007 The American Association for Thoracic Surgery Terms and Conditions