Left ventricular outflow tract vegetation with accessory mitral valve diagnosed by transthoracic and transesophageal echocardiography：a case report
10.3760/cma.j.cn131148-20240903-00469
- VernacularTitle:经胸联合经食管超声心动图诊断左心室流出道赘生物合并二尖瓣副瓣1例
- Author:
Yingang CAI
1
;
Haiyan FENG
1
;
Linlin WANG
1
;
Yan YAN
1
;
Lina SUN
1
Author Information
1. 吉林大学中日联谊医院超声科，长春 130000
- Publication Type:Journal Article
- Keywords:
Echocardiography，transtoracic;
Echocardiography，transesophageal;
Accessory mitral valve;
Left ventricular outflow tract vegetations
- From:
Chinese Journal of Ultrasonography
2025;34(1):52-55
- CountryChina
- Language:Chinese
-
Abstract:
Accessory mitral valve（AMV）refers to the additional valvular structural components connected to the normal mitral valve. It is a rare congenital cardiovascular malformation with an incidence of approximately 1/26 000. Most patients have no obvious symptoms and are often accidentally detected during echocardiography due to the presence of other associated cardiac malformations. The combination of AMV with left ventricular outflow tract（LVOT）vegetations is extremely rare and may be related to infective endocarditis. In this case，a 48-year-old male patient was discovered to have a "cardiac mass" during treatment for a cerebral infarction at an external hospital and was admitted to China-Japan Union Hospital of Jilin University for further diagnosis and treatment. Over the past 3 months，the patient experienced intermittent fever，accompanied by chest tightness and pain during physical exertion. The patient had a history of gout and diabetes. Transthoracic echocardiography（TTE）and transesophageal echocardiography revealed left ventricular outflow tract obstruction，accessory mitral valve（membranous fixed type），and a space-occupying lesion on the ventricular septal side within the left ventricular outflow tract. The final diagnosis of vegetation in the left ventricular outflow tract and accessory mitral valve was confirmed through surgical resection and postoperative pathology. Postoperative TTE showed a significant reduction in the flow velocity and pressure gradient within the left ventricular outflow tract. Echocardiography，with its advantages of simplicity，non-invasiveness，and repeatability，allows for the direct observation of accessory mitral valve and other cardiac abnormalities，evaluation of valve function and hemodynamic changes，and assessment of the left ventricular outflow tract obstruction condition. It facilitates preoperative diagnosis and postoperative follow-up，serving as the gold standard for diagnosing accessory mitral valve.
