Isolated Posterior Mitral Valve Cleft Diagnosed by 3D Echocardiography in an Elderly Woman.

BACKGROUND

Isolated posterior mitral valve cleft (MVC) is a rare congenital anomaly that can be easily overlooked with standard 2-dimensional imaging.

CASE SUMMARY

A 94-year-old woman with progressive heart failure symptoms was found to have severe mitral regurgitation due to an isolated posterior MVC. Three-dimensional echocardiography provided detailed visualization of the lesion's anatomy and confirmed the diagnosis. After excluding a percutaneous repair due to the cleft's complexity, she underwent minimally invasive surgical repair, resulting in substantial symptomatic improvement.

DISCUSSION

Posterior MVCs are infrequently reported and often missed by conventional imaging. Advances in 3-dimensional echocardiography have enhanced diagnostic accuracy, guiding targeted interventions. This case shows the importance of comprehensive imaging for such rare anomalies and the feasibility of surgical repair, even in elderly patients.