Abstract
Although left ventricular outflow tract obstruction is commonly associated with congenitally corrected transposition of the great vessels, this obstruction is seldom caused by accessory mitral valve tissue. Three cases in which accessory mitral valve tissue caused left ventricular outflow tract obstruction in children are described. Two had congenitally corrected transposition and one had normally connected great vessels. The accessory leaflet tissue, which was identified by echocardiography and angiography, was attached by chordae tendineae to normally sited papillary muscles and herniated into the left ventricular outflow tract during systole. Operation was successful in these patients. The accessory valve tissue was excised via an arteriotomy in the great vessel that arose from the left ventricle. The obstructive tissue was excised close to its peripheral attachments in the outflow tract and its chordae tendineae were divided. Resection was performed without injury to the abnormally placed conduction system or to the normal valve structures.
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- Allwork S. P., Bentall H. H., Becker A. E., Cameron H., Gerlis L. M., Wilkinson J. L., Anderson R. H. Congenitally corrected transposition of the great arteries: morphologic study of 32 cases. Am J Cardiol. 1976 Dec;38(7):910–923. doi: 10.1016/0002-9149(76)90804-3. [DOI] [PubMed] [Google Scholar]
- Anderson R. H., Becker A. E., Arnold R., Wilkinson J. L. The conducting tissues in congenitally corrected transposition. Circulation. 1974 Nov;50(5):911–923. doi: 10.1161/01.cir.50.5.911. [DOI] [PubMed] [Google Scholar]
- Anderson R. H., Becker A. E., Gerlis L. M. The pulmonary outflow tract in classically corrected transposition. J Thorac Cardiovasc Surg. 1975 May;69(5):747–757. [PubMed] [Google Scholar]
- Chesler E., Korns M. E., Edwards J. E. Anomalies of the tricuspid valve, including pouches, resembling aneurysms of the membranous ventricular septum. Am J Cardiol. 1968 May;21(5):661–668. doi: 10.1016/0002-9149(68)90263-4. [DOI] [PubMed] [Google Scholar]
- DEAL C. P., Jr, TRUMMER M. J., BELLAMY J. C., TIMMES J. J. A new disease entity: leaflet redundancy of the mitral valve. Am Heart J. 1963 Apr;65:441–445. doi: 10.1016/0002-8703(63)90093-0. [DOI] [PubMed] [Google Scholar]
- Flege J. B., Jr, Vlad P., Ehrenhaft J. L. Aneurysm of the tricuspid valve causing infundibular obstruction. Ann Thorac Surg. 1967 May;3(5):446–448. doi: 10.1016/s0003-4975(10)66452-1. [DOI] [PubMed] [Google Scholar]
- LAUER R. M., DUSHANE J. W., EDWARDS J. E. Obstruction of left ventricular outlet in association with ventricular septal defect. Circulation. 1960 Jul;22:110–125. doi: 10.1161/01.cir.22.1.110. [DOI] [PubMed] [Google Scholar]
- LEVY M. J., LILLEHEI C. W., ELLIOTT L. P., CAREY L. S., ADAMS P., Jr, EDWARDS J. E. Accessory valvular tissue causing subpulmonary stenosis in corrected transposition of great vessels. Circulation. 1963 Apr;27(4 Pt 1):494–502. doi: 10.1161/01.cir.27.4.494. [DOI] [PubMed] [Google Scholar]
- NEUFELD H. N., McGOON D. C., DUSHANE J. W., EDWARDS J. E. Tetralogy of Fallot with anomalous tricuspid valve simulating pulmonary stenosis with intact septum. Circulation. 1960 Dec;22:1083–1090. doi: 10.1161/01.cir.22.6.1083. [DOI] [PubMed] [Google Scholar]
- Rastelli G. C., Wallace R. B., Ongley P. A. Complete repair of transposition of the great arteries with pulmonary stenosis. A review and report of a case corrected by using a new surgical technique. Circulation. 1969 Jan;39(1):83–95. doi: 10.1161/01.cir.39.1.83. [DOI] [PubMed] [Google Scholar]
- Riemenschneider T. A., Goldberg S. J., Ruttenberg H. D., Gyepes M. T. Subpulmonic obstruction in complete (d) transposition produced by redundant tricuspid tissue. Circulation. 1969 May;39(5):603–609. doi: 10.1161/01.cir.39.5.603. [DOI] [PubMed] [Google Scholar]
- SELLERS R. D., LILLEHEI C. W., EDWARDS J. E. SUBAORTIC STENOSIS CAUSED BY ANOMALIES OF THE ATRIOVENTRICULAR VALVES. J Thorac Cardiovasc Surg. 1964 Aug;48:289–302. [PubMed] [Google Scholar]
- Sansa M., Tonkin I. L., Bargeron L. M., Jr, Elliott L. P. Left ventricular outflow tract obstruction in transposition of the great arteries: an angiographic study of 74 cases. Am J Cardiol. 1979 Jul;44(1):88–95. doi: 10.1016/0002-9149(79)90255-8. [DOI] [PubMed] [Google Scholar]
- Summerall C. P., Clowes G. H., Jr, Boone J. A. Aneurysm of ventricular septum with outflow obstruction of the venous ventricle in corrected transposition of great vessels. Am Heart J. 1966 Oct;72(4):525–529. doi: 10.1016/0002-8703(66)90110-4. [DOI] [PubMed] [Google Scholar]



