Congenital Mitral Valve Disease. Seoul National University Hospital Department of Thoracic & Cardiovascular Surgery. Congenital Abnormalities of Mitral Valve. Incidence
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Seoul National University Hospital
Department of Thoracic & Cardiovascular Surgery
Fatigue, DOE, recurrent pulmonary infection,
tachypnea, growth retardation, central cyanosis.
Severely affected infants have CHF with gross
Systolic & diastolic murmur, redistribution of
pulmonary vascularity, cardiac enlargement,
LA enlargement, increased MPA, LV enlargement in MR
1) Associated lesions
2) Symptom & signs
# Abnormalities associated with LVOTO
1. Normal papillary muscle
1) Commissural & papillary fusion
2) Excessive leaflet tissue
3) Valvar ring
4) Annular hypoplasia
2. Abnormal papillary muscle
1) Parachute mitral valve
2) Hammock mitral valve
other malformations are present.
1. Normal motion of the leaflet (type I)
1) Deformation & dilatation
3) Partial agenesis
2. Prolapse of leaflet (type II)
1) Absence of tendinous cords
2) Elongation of tendinous cords
3) Elongation of papillary m.
3. Restricted motion of leaflet (type III)
1) Normal papillary m.
commissural fusion / shortness of cords
2) Abnormal papillary m.
parachute / Hammock / hypoplasia of papillary m. / Ebstein malformation / double orifice
with Ring(1) after annular
plication with resected
posterior median leaflet(2)
1. Postoperative valvular incompetence
most common ; mild in 15% by Echo
2. LVOT obstruction : 3%
3. Suture line dehiscence : 2%
4. Dehiscence of prosthetic ring, fracture, hemolysis
5. Aortic regurgitation : infrequent