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INTERESTING IMAGE
Year : 2015  |  Volume : 1  |  Issue : 3  |  Page : 169-170

Double orifice mitral valve in patient with partial atrioventricular septal defect


1 Department of Cardiothoracic and Vascular Surery, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India
2 Department of Cardiac Anaesthesia, GB Pant Institute of Postgraduate Medical Education and Research, New Delhi, India

Date of Web Publication30-Sep-2015

Correspondence Address:
Swarnika Srivastava
GIPMER, New Delhi
India
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Source of Support: Nil., Conflict of Interest: There are no conflicts of interest.


DOI: 10.4103/2394-7438.166311

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How to cite this article:
Srivastava S, Agarwal S, Virmani S, Satsangi DK, Raja N. Double orifice mitral valve in patient with partial atrioventricular septal defect. MAMC J Med Sci 2015;1:169-70

How to cite this URL:
Srivastava S, Agarwal S, Virmani S, Satsangi DK, Raja N. Double orifice mitral valve in patient with partial atrioventricular septal defect. MAMC J Med Sci [serial online] 2015 [cited 2019 Aug 22];1:169-70. Available from: http://www.mamcjms.in/text.asp?2015/1/3/169/166311



Double orifice mitral valve (DOMV) is a rare anomaly that was first described by Greenfield in 1876.[1] This condition involves two mitral valve annuli and valves, each with its own set of leaflets, commissures, chordae, and papillary muscles. DOMV can occur very rarely as an isolated anomaly,[2] or associated with lesions such as atrioventricular (AV) septal defect (endocardial cushion defect), ventricular septal defect, coarctation of the aorta, interrupted aorticarch, subaorticstenosis, patentductusarteriosus, andprimumatrial septal defect.[3]

We present a patient with DOMV associated with partial AV septal defect. The patient had two mitral orifices, each of which had a separate annulus and subvalvular apparatus. The larger of the two orifices had cleft in the anterior leaflet which was causing the regurgitation [Figure 1].
Figure 1: Intraoperative image showing two mitral orifices, each having a separate annulus and subvalvular apparatus (arrow). The larger of the two had a cleft in the anterior leaflet

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Surgical repair was performed by cleft closure of the anterior leaflet of larger mitral orifice and ostium primum septal defect closure by pericardial patch [Figure 2].
Figure 2: Intraoperative image showing repair of the cleft present in the anterior leaflet of the larger mitral valve. The arrow shows suture line of the cleft. The forceps separates the two valve orifice ventricular septal defecthad

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Postoperatively, three-dimensional echocardiogram was performed, which revealed minimum regurgitation and no stenosis [Figure 3] and [Figure 4].
Figure 3: Live three-dimensional echocardiogram short axis view where the arrow shows two separate papillary muscle bundle shown as muscle groove, thus signifying true double orifice left atrioventricular valve

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Figure 4: Two-dimensional echocardiogram of a double-orifice mitral valve (apical view) with color flow mapping, which shows diastolic flow through two separate orifices

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Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.







 
  References Top

1.
Greenfield WS. Double mitral valve. Trans Pathol Soc 1876;27:128-9.  Back to cited text no. 1
    
2.
Anwar AM, McGhie JS, Meijboom FJ, Ten Cate FJ. Double orifice mitral valve by real-time three-dimensional echocardiography. Eur J Echocardiogr 2008;9:731-2.  Back to cited text no. 2
    
3.
Warnes C, Somerville J. Double mitral valve orifice in atrioventricular defects. Br Heart J 1983;49:59-64.  Back to cited text no. 3
    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4]



 

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