Istinye University, Faculty of Medicine Department of Cardiology, Istanbul Turkey.
Beykent University, Faculty of Medicine Department of Cardiology, Istanbul Turkey.
Cardiovasc Pathol. 2021 Jan-Feb;50:107277. doi: 10.1016/j.carpath.2020.107277. Epub 2020 Aug 31.
Mitral valve is a complex cardiac structure composed of several components to work in synchrony to allow blood flow into left ventricle during diastole and not to allow blood flow into left atrium during systole. Accessory mitral valve tissue (AMVT) was defined as existence of any additional part and parcel of valvular structure which has an attachment to normal mitral valve apparatus in left-sided cardiac chambers. AMVT may present itself in different clinical circumstances ranging from a silent clinical course to thromboembolic events, heart failure, left ventricular outflow tract obstruction, and severe arrhythmia. This article reviews the clinical perspectives of AMVT in terms of symptoms, diagnosis, and treatment, providing a new anatomical classification regarding the location of AMVT. Briefly type I refers to AMVT having attachments on the supra leaflets level, type II refers to attachments on the mitral leaflets, and type III refers to attachment below the mitral leaflets. Increased awareness and widespread use of echocardiographic techniques would increase recognition of AMVT in patients with heart murmurs but otherwise healthy and in those with left ventricular outflow tract obstruction or tissue which causes subaortic stenosis and with unexplained cerebrovascular events.
二尖瓣是一种复杂的心脏结构，由几个组成部分组成，这些组成部分协同工作，在舒张期允许血液流入左心室，而在收缩期则不允许血液流入左心房。二尖瓣附属组织（AMVT）被定义为左心室内存在任何附着于正常二尖瓣装置的瓣膜结构的附加部分。AMVT 可能在不同的临床情况下出现，从无症状的临床病程到血栓栓塞事件、心力衰竭、左心室流出道梗阻和严重心律失常。本文从症状、诊断和治疗方面回顾了 AMVT 的临床观点，提供了关于 AMVT 位置的新的解剖学分类。简要地说，I 型指的是 AMVT 在瓣上叶水平有附着，II 型指的是在二尖瓣叶上有附着，III 型指的是在二尖瓣叶下有附着。提高对 AMVT 的认识并广泛应用超声心动图技术，将增加对有心脏杂音但 otherwise 健康的患者、左心室流出道梗阻或导致主动脉瓣下狭窄的组织以及不明原因的脑血管事件患者的 AMVT 的识别。
