Severe degenerative prolapse hiding a double-orifice mitral valve

Abstract

A 57-year old woman was diagnosed with severe mitral regurgitation secondary to A2 prolapse. Intraoperative transesophageal echocardiography showed prolapse of the A2-P2 (Fig. 1a and b; Supplementary Videos 1 and 2), and 3D-echocardiography disclosed a double-orifice valve (Fig. 1c). The valve was successfully repaired with a posterior triangular resection and A2-anchoring with artificial chordae. Supplementary material (Videos 1 and 2) is available at EJCTS online. Video 1: 2D-echocardiography (4-chamber view): Severe A2 and minor P2 prolapse leading to severe mitral regurgitation can be observed. Video 2: Large A2 and minor P2 prolapses are observed in systole. In diastole we notice opening containment because of leaflet bridging to form an asymmetric double-orifice valve.