Incidental detection of accessory mitral valve in adolescent with atrial septal defect: Diagnosis with 3D transesophageal echocardiography and excision with transaortic method

• Published in: Echocardiography (Mount Kisco, N.Y.) Vol. 39; no. 6; pp. 851 - 854
• Main Authors: Azak, Emine, Aydın, Nuri Hakan, Ecevit, Niyazi Ata, Cetin, Ibrahim Ilker, Golbasi, Zehra
• Format: Journal Article
• Language: English
• Published: United States 01-06-2022
• Subjects: 3D‐transesophageal echocardiography; accessory mitral valve tissue; left ventricular outflow tract obstruction; 3D-transesophageal echocardiography; left ventricular outflow tract obstruction; accessory mitral valve tissue
• ISSN: 0742-2822; 1540-8175
• DOI: 10.1111/echo.15369

ABSTRACT
Background
Accessory mitral valve tissue (AMVT) is an extremely rare causes left ventricular outflow tract (LVOT) obstruction and is usually incidentally detected in childhood. It is often associated with other cardiac and vascular congenital malformations.
Case Presentation
In this case, we present a 15‐year‐old girl was diagnosed with AMVT by transesophageal echocardiography, resulting in LVOT obstruction during systole. Interestingly enough, the patient's accessory mitral valve remained undetected for years until he became symptomatic for wide ASD. Successful closure of the ASD with resection of the AMVT was performed with a transaortic approach. The patient was hemodynamically stable postoperatively. There were no abnormalities in the mitral valves and LVOT.
Conclusion
It was also unusual to see AMVT with ASD instead of other frequently associated other congenital anomalies. Accessory mitral valve should be considered a rare but important cause of left ventricular outflow tract obstruction in childhood.