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Abstract：
BACKGROUND: Accessory mitral valve tissue rarely causes left ventricular outflow tract obstruction in adults. It is often associated with other cardiac and vascular congenital malformations. Here, we report the rarest presentation of accessory mitral valve tissue (AMVT) causing left ventricular outflow tract obstruction.
METHODS: A 22-year-old female patient presented with a history of shortness of breath and chest pain for more than 5 years. A diagnosis of AMVT with parachute mitral valve, ventricular septal defect (VSD), bicuspid aortic valve, unruptured aneurysm of aortic sinus, and left ventricular outflow tract obstruction was made. Successful closure of VSD with mitral valve replacement, excision of AMVT, and repair of the aortic sinus were performed. The post-operative course was uneventful, and an echocardiogram showed complete resection of the accessory mitral valve, no residual shunt and no left ventricular outflow gradient. Additionally, the peak gradient of rapid filling phase and atrial systolic phase across the prosthetic mitral valve were 16 mmHg and 4 mmHg, respectively. The peak velocity across left ventricular outflow tract was 1.4 m/s.
CONCLUSIONS: Accessory mitral valve tissue is associated with other cardiac abnormalities and is usually diagnosed in the first or second decade of life. It is responsible for left ventricular outflow tract obstruction. The obstruction can occur in the early period of life due to continued deposition of fibrous tissues within left ventricular outflow tract. Accessory mitral valve tissue should be considered a rare but important cause of left ventricular outflow tract obstruction.
METHODS: A 22-year-old female patient presented with a history of shortness of breath and chest pain for more than 5 years. A diagnosis of AMVT with parachute mitral valve, ventricular septal defect (VSD), bicuspid aortic valve, unruptured aneurysm of aortic sinus, and left ventricular outflow tract obstruction was made. Successful closure of VSD with mitral valve replacement, excision of AMVT, and repair of the aortic sinus were performed. The post-operative course was uneventful, and an echocardiogram showed complete resection of the accessory mitral valve, no residual shunt and no left ventricular outflow gradient. Additionally, the peak gradient of rapid filling phase and atrial systolic phase across the prosthetic mitral valve were 16 mmHg and 4 mmHg, respectively. The peak velocity across left ventricular outflow tract was 1.4 m/s.
CONCLUSIONS: Accessory mitral valve tissue is associated with other cardiac abnormalities and is usually diagnosed in the first or second decade of life. It is responsible for left ventricular outflow tract obstruction. The obstruction can occur in the early period of life due to continued deposition of fibrous tissues within left ventricular outflow tract. Accessory mitral valve tissue should be considered a rare but important cause of left ventricular outflow tract obstruction.
摘要：
背景：附件二尖瓣组织很少引起成人左心室流出道阻塞。它通常与其他心脏和血管先天性畸形有关。这里,我们报告了引起左心室流出道阻塞的最罕见的副二尖瓣组织（AMVT）。
方法：一名22岁女性患者，有超过5年的呼吸急促和胸痛病史。AMVT伴降落伞二尖瓣的诊断,室间隔缺损(VSD),二叶主动脉瓣,主动脉窦未破裂动脉瘤,左心室流出道梗阻。二尖瓣置换术成功关闭室间隔缺损，AMVT切除,并进行主动脉窦修复。手术后的过程很顺利，超声心动图显示副二尖瓣完全切除，没有残余分流和左心室流出梯度。此外,二尖瓣快速充盈期和心房收缩期的峰值梯度分别为16mmHg和4mmHg,分别。左心室流出道的峰值速度为1.4m/s。
结论：副二尖瓣组织与其他心脏异常有关，通常在生命的第一个或第二个十年被诊断出来。它是造成左心室流出道梗阻的原因。由于左心室流出道内纤维组织的持续沉积，阻塞可能发生在生命的早期。附件二尖瓣组织应被认为是左心室流出道阻塞的罕见但重要的原因。
方法：一名22岁女性患者，有超过5年的呼吸急促和胸痛病史。AMVT伴降落伞二尖瓣的诊断,室间隔缺损(VSD),二叶主动脉瓣,主动脉窦未破裂动脉瘤,左心室流出道梗阻。二尖瓣置换术成功关闭室间隔缺损，AMVT切除,并进行主动脉窦修复。手术后的过程很顺利，超声心动图显示副二尖瓣完全切除，没有残余分流和左心室流出梯度。此外,二尖瓣快速充盈期和心房收缩期的峰值梯度分别为16mmHg和4mmHg,分别。左心室流出道的峰值速度为1.4m/s。
结论：副二尖瓣组织与其他心脏异常有关，通常在生命的第一个或第二个十年被诊断出来。它是造成左心室流出道梗阻的原因。由于左心室流出道内纤维组织的持续沉积，阻塞可能发生在生命的早期。附件二尖瓣组织应被认为是左心室流出道阻塞的罕见但重要的原因。
