Key result
Minimally invasive surgical repair of an isolated posterior mitral valve cleft in a 94-year-old woman resulted in no residual mitral regurgitation and substantial symptomatic improvement.
Why the study?
Isolated posterior mitral valve cleft is a rare congenital anomaly that can be easily overlooked with standard 2-dimensional imaging.
Case Report (n=1)
No
3D echocardiography is crucial for diagnosing rare isolated posterior mitral valve clefts, and surgical repair can be safely and effectively performed to provide symptom relief even in very elderly patients.
Surgical repair appears feasible in very elderly patients with rare mitral clefts; leaves open need for larger series before broader adoption.
BACKGROUND: Isolated posterior mitral valve cleft (MVC) is a rare congenital anomaly that can be easily overlooked with standard 2-dimensional imaging. CASE SUMMARY: A 94-year-old woman with progressive heart failure symptoms was found to have severe mitral regurgitation due to an isolated posterior MVC. Three-dimensional echocardiography provided detailed visualization of the lesion's anatomy and confirmed the diagnosis. After excluding a percutaneous repair due to the cleft's complexity, she underwent minimally invasive surgical repair, resulting in substantial symptomatic improvement. DISCUSSION: Posterior MVCs are infrequently reported and often missed by conventional imaging. Advances in 3-dimensional echocardiography have enhanced diagnostic accuracy, guiding targeted interventions. This case shows the importance of comprehensive imaging for such rare anomalies and the feasibility of surgical repair, even in elderly patients.
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Khalil et al. (2025) conducted a case report in Isolated posterior mitral valve cleft with severe mitral regurgitation (n=1). Minimally invasive surgical repair (direct suture and annuloplasty) was evaluated on Clinical improvement and residual mitral regurgitation. Minimally invasive surgical repair of an isolated posterior mitral valve cleft in a 94-year-old woman resulted in no residual mitral regurgitation and substantial symptomatic improvement.