Parachute mitral valve associated with reticular chordae tendineae in an adult: case report

Figures

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  Fig. 1. a. Transthoracic two-dimensional echocardiography showing abnormal chordae tendineae with reticular structures (arrow) and slightly thickened mitral leaflets in systole. b. Parasternal long-axis view showing pear-shaped mitral orifice during diastole (arrow) with chords attached to the posteromedial papillary muscle, with the leaflets forming the larger base of the pear and the chordae tendinae the apex. c. A single large papillary muscle in short-axis format was detected. A small muscular ridge or trabecula was present at the location of anterolateral papillary muscle without any chordal attachment. d. Reticular chordae tendineae with scattered holes among them was confirmed in 3D transesophageal echocardiography

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  Fig. 2. a. The chordae tendinae were lengthy and thick. The leaflets were slightly thichened. A distinctive reticular fibrous diaphragm with scattered holes was found on mitral valve apparatus as the chordae tendinae intermixed each other. B, C, D. The valve was displayed in saline and was shown in different views. The only functional communication between the left atrium and the left ventricular was through the reticular spaces. Noting that the arrow marked small chodae tendinae in Fig. 2a, c, d did not attach to any other small papillary muscle or the ventricle wall. It was actually attached to the reticular fibrous diaphragm. The attachment point was marked with asterisk mark in Fig. 2a. This small chordate tendinae was inadvertently cut from the fibrous diaphragm during the resection of mitral valve