CC BY-NC-ND 4.0 · THORAC CARDIOV SURG Reports 2019; 08(01): e18-e19
DOI: 10.1055/s-0039-1692155
Case Report: Cardiac
Georg Thieme Verlag KG Stuttgart · New York

Muscular Mitral Chord Contribution to Left Ventricular Outflow Tract Obstruction in HOCM

Olayinka Ogunmuyiwa
1  Department of Cardiovascular Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
,
Philipp Rellecke
1  Department of Cardiovascular Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
,
Artur Lichtenberg
1  Department of Cardiovascular Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
,
Alexander Assmann
1  Department of Cardiovascular Surgery, Heinrich Heine University, Medical Faculty, Düsseldorf, Germany
› Author Affiliations
Further Information

Publication History

14 March 2019

01 April 2019

Publication Date:
16 June 2019 (online)

  

Abstract

Papillary muscle anomaly with a muscular chord directly attached to the anterior mitral leaflet is a rare mitral valve disease. A 62-year-old man with systolic anterior motion of the anterior mitral leaflet and hypertrophic obstructive cardiomyopathy presented to surgical intervention after unsuccessful transcoronary ablation of septal hypertrophy with alcohol. Intraoperative findings revealed a primarily not detected anomalous muscular mitral chord (0.8 × 2.2 cm) connecting the base of the A1 segment to the anterolateral papillary muscle. Resection of this chord and additional septal myectomy treated systolic anterior motion and obstruction of the outflow tract. In spite of the infrequent occurrence, anomalies of the subvalvular apparatus, such as muscular chords, should be ruled out by thorough transesophageal echocardiography imaging before decision on the therapeutical strategy.