Mitral Valve Prolapse Associated with Atrial Level Communication

Abstract

Objectives: The association of mitral valve disorder and atrial communication, either atrial septal defect or patent foramen ovale, remains a topic of debate over time. The aim of the present article is to describe the clinical features of this entity. Methods: Eighteen patients with an atrial communication that required closure were selected into this study, and were divided into two groups: Group A patients were associated with mitral valve prolapse, and Group B patients were not. Results: Pulmonary hypertension was noted in eight patients of Group A, and in one patient of Group B. Three patients in Group A and none of Group B had infective endocarditis. Group A patients had larger left ventricular diastolic dimension, left atrial dimension, and tricuspid valve peak systolic pressure gradient than Group B patients. Regression analysis revealed an inverse relationship between left ventricular diastolic dimension and peak systolic pressure gradient across the tricuspid valve in Group A (p=0.033), but no significant correlation was noted in Group B (p=0.183). Conclusions: The presence of mitral valve prolapse with various degrees of mitral regurgitation in the patients with atrial level communication may implicate an impaired diastolic function of the left ventricle, and increased pulmonary artery pressure. Surgical intervention to the atrial level communication and mitral regurgitation may lead to a better prognosis in such patients.