Tsuchida H, Hirayama T, Yamaguchi H, Ishimaru S, Furukawa K, Takahashi M
Second Department of Surgery, Tokyo Medical College, Japan.
Nihon Kyobu Geka Gakkai Zasshi. 1990 Feb;38(2):303-6.
A case of mitral regurgitation (MR) due to perforation of the mitral posterior leaflet is described. A 48-year-old male patient was admitted to the hospital because of left heart failure. A pan-systolic murmur was audible in the mitral area. Left ventriculography revealed MR. A spindle shaped perforation (about 8 X 3 mm in size) was found intraoperatively in the posterior leaflet of the mitral valve near the posterior commissure. The surface around the perforation was smooth, and the leaflet displayed good movability. No vegetation or calcification was found. Valvuloplasty was performed and the perforation was closed. The patient was regularly examined for 3 years post-surgery, and no recurrence of MR was found. The cause of this perforation was unknown but it is thought to be acquired. MR resulting only from mitral valve perforation is extremely rare. The pathogenesis and problems of diagnosis are discussed in this report.
