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Congenital mitral stenosis
Published in Neeraj Parakh, Ravi S. Math, Vivek Chaturvedi, Mitral Stenosis, 2018
Danny Manglani, Saurabh Kumar Gupta
Parachute mitral valve (PMV) results from both leaflets attaching to a single mass of papillary muscle(s). The initial description by Shone and colleagues included hearts with a solitary papillary muscle.33 More often, however, the appearance results from fusion of two closely placed papillary muscles (Figure 19.5). Generally, the anterolateral muscle is hypoplastic and the posteromedial papillary muscle is dominant. There has been considerable controversy in defining what constitutes PMV. Rosenquist34 and Carpentier15 et al. included those with fused papillary muscles while Ruckman and Van Praagh13 excluded them from the label of PMV. From a practical viewpoint, both these variants have similar appearance and hemodynamic impact. Generally, children with typical single papillary muscle variant are labeled “PMV,” while others with two fused papillary muscles, symmetric or asymmetric, are said to have “parachute-like mitral valve (PLMV).”35 This distinction is important for valve reconstruction surgery (see later).
Interventional cardiac catheterisation in adults with congenital heart disease
Published in Ever D. Grech, Practical Interventional Cardiology, 2017
Hussam S Suradi, Ziyad M Hijazi
The incidence of congenital mitral stenosis is very low and is frequently associated with other CHD. This includes cleft mitral valve seen in association with AV canal defects that may have undergone repair. Mitral stenosis may also present as a variant of ‘Shone's Complex’ with multiple left-sided heart abnormalities. Another uncommon presentation is ‘parachute’ mitral valve that involves abnormal chordal attachments. Unlike rheumatic mitral valve stenosis, congenital mitral stenosis is generally not suitable for balloon valvuloplasty.
Breathlessness in Pregnancy: Cardiac Causes
Published in Tony Hollingworth, Differential Diagnosis in Obstetrics and Gynaecology: An A-Z, 2015
The commonest chronic rheumatic valvular lesion in pregnancy in the UK is mitral stenosis, particularly in the immigrant population from the Indian subcontinent, China, Eastern Europe, and East African countries. Since rheumatic mitral stenosis can remain silent up until the third decade, symptoms may often first appear during pregnancy. Congenital fusion of the commissures, or ‘parachute mitral valve’, and left atrial myxoma are other causes of mitral stenosis during pregnancy.
Diagnosis of Shone syndrome on CT angiography in an adult
Published in Acta Cardiologica, 2021
Vineeta Ojha, Akash Vadher, S. H. Chandrashekhara, Amarinder Singh Malhi, Sanjeev Kumar
A 29-year female patient presented with complaints of dyspnoea on exertion for 4 months. Echocardiography revealed subaortic membrane and absent anterolateral papillary muscle with parachute mitral valve. There was a gradient of 40 mm Hg across the aortic valve. CT angiography, done to look for any other aortic pathology, revealed thin incomplete mitral supravalvular membrane, an incomplete subaortic membrane and post-ductal coarctation of aorta. The anterolateral papillary muscle of the left ventricle was not seen and chordae tendinae from both leaflets of mitral valve were seen to be attached to posteromedial papillary muscles, suggestive of parachute mitral valve (Figure 1). The mitral valve leaflets were thickened. Diagnosis of Shone syndrome was made based on the spectrum of CT findings.