PMC3184715_01
Transthoracic echocardiogram in different views showing accessory mitral valve tissue attached to ventricular aspect of anterior mitral valve leaflet prolapsing into left ventricular outflow tract in systole (A, B, C arrowheads) in a post-Senning surgery patient.
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F1
There was a well defined mobile leaflet-like structure measuring 1.3x0.5 cm, prolapsing in systole into the LVOT (Figure 1A and B, arrowheads). On careful examination, the mobile mass represented an AMVT which was seen to adhere to the ventricular side of the anterior mitral valve leaflet (Figure 1C, arrowheads, Movie 1) and prolapsing into the LVOT during systole.
(A) Color Doppler echocardiogram showing severe turbulence in the left ventricular outflow tract. (B) Continuous wave Doppler examination showing severe left ventricular outflow tract obstruction with peak gradient of 79 mmHg and a mean gradient of 49 mmHg, in a patient with accessory mitral valve tissue.
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F2
On color Doppler examination, there was severe turbulence in the LVOT (Figure 2A) with LVOT peak gradient of 79 mmHg and a mean gradient of 49 mmHg (Figure 2B).