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      Severe Mitral Regurgitation Secondary to Atresia of the Posterior Mitral Valve Leaflet in the Adult: Is Repair Always Best Practice?

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          Abstract

          We describe a case of a 66-year-old woman with severe mitral regurgitation secondary to posterior leaflet atresia of the mitral valve. Perioperative transesophageal echocardiography suggested the possibility of an absent posterior leaflet with complete prolapse of the anterior leaflet. We questioned the functional outcome if repair was attempted; therefore, mitral valve replacement was performed. We present a case outlining the successful management of this rare condition in an adult as well as a review of current literature.

          Most cited references7

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          Prevalence of asymptomatic mitral valve malformations.

          Congenital abnormalities of the mitral valve are considered to be very rare cardiac anomalies. In particular, more severe malformations, such as the complete absence of either aortic (anterior) or mural (posterior) mitral leaflet, are usually considered to be incompatible with life. Ebstein-like malformation of the mitral valve is an extremely rare form of mitral valve deformity hitherto unreported in an asymptomatic adult patient.
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            Functionally uni-leaflet mitral valves in a family: a case series.

            Functionally uni-leaflet mitral valves are extremely rare. In severe cases, they are considered incompatible with life beyond the neonatal period. We present a case series of three adults with almost complete absence of the posterior mitral valve leaflet and who are asymptomatic, with no more than mild mitral regurgitation. We believe that this is the first reported instance of such findings in a single family.
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              Severe hypoplasia of the posterior mitral leaflet.

              A rare case of a 14-year-old child with congenital mitral insufficiency secondary to hypoplasia of the posterior leaflet is reported. Echocardiography revealed the almost complete absence of the posterior mitral leaflet, which determined massive regurgitation. At surgical inspection the posterior leaflet was almost completely absent, represented only by tags of fibrous tissue that strictly adhered to the posterior annulus with a total absence of chordae inserting into the hypoplastic leaflet. The mitral valve was successfully repaired by restrictive annuloplasty, which gained a satisfactory surface of coaptation between the anterior leaflet and the primordial posterior structure, resulting in stable valve continence.
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                Author and article information

                Journal
                Thorac Cardiovasc Surg Rep
                Thorac Cardiovasc Surg Rep
                10.1055/s-00024355
                The Thoracic and Cardiovascular Surgeon Reports
                Georg Thieme Verlag KG (Stuttgart · New York )
                2194-7635
                2194-7643
                15 December 2014
                December 2015
                : 4
                : 1
                : 34-36
                Affiliations
                [1 ]Department of Cardiac Surgery, Nottingham City Hospital, Nottingham, United Kingdom
                [2 ]Department of Cardiac Anaesthesia, Nottingham City Hospital, Nottingham, United Kingdom
                Author notes
                Address for correspondence Kaye Laurie Department of Cardiac Surgery, Nottingham City Hospital Hucknall Rd, Nottingham NG5 1PBUnited Kingdom kayeprosser@ 123456nhs.net
                Article
                130063crc
                10.1055/s-0034-1394104
                4670300
                26693125
                766182cd-8ce8-42f1-83b7-305ad05a67c0
                © Thieme Medical Publishers
                History
                : 15 December 2013
                : 19 August 2014
                Categories
                Article

                cardiac surgery,mitral valve repair,heart valve disease

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