The angiographic features of a case of parachute mitral valve

Left ventricular inflow obstruction and atrial septal defect: diagnosis by real time two-dimensional echocardiography

This report describes the usefulness of real time two-dimensional echocardiography in the diagnosis of left ventricular inflow obstruction associated with atrial septal defect. Echocardiographically, left ventricular inflow obstruction was at the level of the mitral valve in case one, mitral and subvalvular in cases 2 and 3 and supravalvular in case 4 (left atrial membrane). In all patients the defect was of the secundum variety and was seen as a constant discontinuity in the atrial septal image. The diagnosis was confirmed in all patients by cardiac catheterization, surgery or autopsy.

Congenital obstructive lesions involving the major pulmonary veins, left atrium, or mitral valve: a clinical, laboratory, and morphologic survey

The clinical, laboratory, and morphologic features of congenitally obstructive lesions causing pulmonary venous hypertension are reviewed. These lesions are responsible for considerable infant mortality and morbidity, especially in the first weeks of life, are not infrequently encountered in older children, and are occasionally seen in adults. The presence of a malformation causing pulmonary venous hypertension often can be detected clinically, but precise anatomical and physiological diagnoses, usually necessary for optimal patient management, often can be made only by detailed laboratory study. Cardiac catheterization and angiocardiography remain the prime modes of accurate diagnosis in such patients, many of whom have other significant cardiovascular malformations, and echocardiography is an extremely useful adjunct, especially in patients with mitral valvular stenosis, hypoplasia, or atresia. The only definitive treatment in any of these patients is operative relief of the obstruction, and the chances of success depend not only on the skill of the surgeon, but also on the nature of the obstructing lesion, the types of associated malformations, and the precision with which these are defined preoperatively.

Diagnosis and management of parachute mitral valve and supravalvar mitral ring

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Congenital mitral valve disease associated with coarctation of the aorta: a spectrum that includes parachute deformity of the mitral valve

Fifty-three specimens in which the primary diagnosis in life was coarctation of the aorta were examined; only nine had a mitral valve of normal size and configuration. Ten specimens had a normally formed valve mechanism which was small in comparison to both tricuspid valve and left ventricle. Three other specimens had a normally formed but small valve which exhibited a short free margin of the anterior leaflet. The remaining 31 specimens demonstrated various anomalies which included some forms of parachute mitral valve. The spectrum of malformations may be divided into three basic types: some showed fused or closely apposed chordae tendineae, due to nondevelopment of the intervening space; in others the space between the papillary muscles and the ventricular wall was underdeveloped, which prevented the papillary muscles from moving independently of the ventricular wall. The third type was found in a case of parachute mitral valve, where the chordae tendineae were attached solely to the anterolateral papillary muscle, and the posteromedial papillary muscle was inserted directly into the valve, near the annulus. Although the spectrum of congenital anomalies reported here does not include all forms of mitral stenosis, it does indicate that mitral valve disease probably occurs more frequently in coarctation of the aorta than previously was recognized.

Cardiomyopathy associated with congenital heart disease

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