Accessory mitral valve tissue: an updated review of the literature

Eur Heart J Cardiovasc Imaging. 2014 May;15(5):489-97. doi: 10.1093/ehjci/jet163. Epub 2013 Oct 27.

Abstract

Accessory mitral valve tissue (AMVT) is a rare congenital cardiac anomaly sometimes responsible for left ventricular outflow tract (LVOT) obstruction. It is diagnosed during both neonate-childhood and adult periods in patients usually symptomatic for dyspnoea, chest pain, palpitations, fatigue, or syncope. Nevertheless, AMVT is often an incidental finding. AMVT is most often associated with other cardiac and vascular congenital malformations, such as septal defects and transposition of the great arteries. Surgery is indicated only in cases of significant LVOT obstruction and in patients undergoing correction of other cardiac malformations or exploration of an intracardiac mass. Two-dimensional echocardiography, both transthoracic and transoesophageal, is considered the main imaging modality for AMVT diagnosis and patient follow-up. The recent introduction of three-dimensional echocardiography allows a more realistic characterization of this entity. We present three clinical cases in which AMVT was incidentally diagnosed during standard echocardiography and an updated review of the literature highlighting the usefulness of echocardiography for AMVT morphological and functional characterization as well as the most relevant clinical implications due to its discovery.

Keywords: Accessory mitral valve tissue; Echocardiography; Left ventricular outflow tract obstruction.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Cardiac Surgical Procedures / methods*
  • Diagnosis, Differential
  • Echocardiography / methods*
  • Echocardiography, Three-Dimensional
  • Echocardiography, Transesophageal
  • Electrocardiography
  • Female
  • Heart Defects, Congenital / diagnostic imaging*
  • Heart Defects, Congenital / surgery
  • Humans
  • Incidental Findings
  • Male
  • Middle Aged
  • Mitral Valve / abnormalities*
  • Mitral Valve / diagnostic imaging
  • Mitral Valve / surgery
  • Ventricular Outflow Obstruction / diagnostic imaging*
  • Ventricular Outflow Obstruction / surgery