CASE PRESENTATİON
A 28-year-old female patient was admitted to the cardiology outpatient
clinic with the complaint of shortness of breath for two years. Her
medical history was not significant. Cardiac auscultation showed a 3/6
grade holosystolic murmur on the left sternal border. Her
electrocardiogram (ECG) revealed no significant abnormalities. The
transthoracic echocardiography (TTE) had revealed severe mitral
regurgitation from the anterior leaflet, left atrial enlargement, mild
tricuspid insufficiency, a normal systolic function (LVEF %60), an
intact interatrial septum, and elevated systolic pulmonary artery
pressure (33 mmHg). The transesophageal echocardiography (TEE) showed a
cleft that was between the mitral valve A1 and A2 scallops, and severe
regurgitation flow was detected from the cleft region and mild
regurgaiton flow was detected from the coaptation line. Systolic
inversion of pulmonary venous flow was also found. (Video 1, Video 2)
The patient was evaluated by the heart team and underwent mitral valve
repair with directed cleft suture. Postoperative TTE revealed very good
results of mitral valve repair and a mild pericardial effusion. The
patient was discharged.
A 19-year-old female was referred to our outpatient clinic with
suspected congenital heart disease. At admission the patient was
asymptomatic. Her medical history was not significant. Cardiac
auscultation showed a 2/6 grade holosystolic murmur on the mitral area.
Her ECG showed normal sinus rhythm. A previous TTE had revealed a
moderate mitral regurgitation from the anterior leaflet, a conserved
systolic function (LVEF %60), an intact interatrial septum, and normal
systolic pulmonary artery pressure. The TEE revealed thickening of the
mitral valve A2P2 and A3P3 scallops, a cleft between the A2A3 scallops
and moderate-severe mitral regurgitation from the cleft and moderate
mitral regurgation from the coaptation line. (regurgitant volume 36
mL/beat) (Video 3, 4) The follow-up of the asymptomatic patient
continues.