De Souza A M, Silva C E, Ortiz J, Matsumoto A Y
Centro de Cardiologia Náo Invasiva, Sáo Paulo.
Arq Bras Cardiol. 1990 Aug;55(2):121-4.
The accessory mitral valve leaflet is a rare cardiac congenital anomaly usually associated to complex cardiac congenital malformations. It also represents a rare cause of left ventricular outflow tract obstruction. Its diagnosis has often been ignored by conventional diagnostic methods. This fact may represent a cause for relative surgical failure, when operations for cardiac complex anomalies are performed. Echodopplercardiography is the choice and more accurate method for its diagnosis. In our case, parasternal and apical long axis planes, allowed an unmistakable visualization of a parachute shape fibrous structure, with its concave surface turned up towards the aortic valve. Chordae tendinae proper to the anomalous accessory mitral valve tissue were connected to chordae or to papillary muscles of the mitral valve. A careful echodopplercardiographic study will allow us, not only to diagnose this malformation, as well as to differentiate it from other conditions like tumors, vegetations or other types of subaortic obstruction.
二尖瓣副瓣是一种罕见的心脏先天性异常，通常与复杂的心脏先天性畸形相关。它也是左心室流出道梗阻的罕见原因。其诊断常被传统诊断方法忽视。这一事实可能是在进行心脏复杂畸形手术时导致相对手术失败的一个原因。超声心动图是诊断该病的首选且更准确的方法。在我们的病例中，胸骨旁和心尖长轴切面能清晰显示一个降落伞状纤维结构，其凹面朝向主动脉瓣。异常二尖瓣副瓣组织的腱索与二尖瓣的腱索或乳头肌相连。仔细的超声心动图检查不仅能使我们诊断出这种畸形，还能将其与其他情况如肿瘤、赘生物或其他类型的主动脉下梗阻区分开来。
