Key result
Surgical resection of accessory mitral valve tissue resolves LVOT obstruction without recurrence at 3 years.
Why the study?
Accessory mitral valve tissue is a rare congenital anomaly typically diagnosed in childhood and often overlooked in elderly patients presenting with left ventricular outflow tract obstruction.
Case Report (n=1)
No
Accessory mitral valve tissue, a rare congenital anomaly, can present as dynamic LVOT obstruction in elderly patients and is effectively treated with surgical resection.
AMVT may cause LVOT obstruction in the elderly; hypothesis-generating for inclusion in adult differential diagnoses.
BACKGROUND: Accessory mitral valve tissue (AMVT) is a rare congenital anomaly that is typically diagnosed during childhood and overlooked in elderly patients presenting with left ventricular outflow tract (LVOT) obstruction. CASE SUMMARY: A 73-year-old man presented with exertional presyncope and a systolic murmur. Transthoracic echocardiography revealed a mobile sac-like structure protruding into the LVOT, causing a 74 mm Hg gradient despite a normal aortic valve. Multimodal imaging confirmed a type IIB2 AMVT with dynamic prolapse. Surgical resection and histological analysis confirmed valve-like tissues. At the 3-year follow-up, the patient had remained asymptomatic with no recurrence. DISCUSSION: This case shows that AMVT, although congenital, can rarely present in elderly individuals. A crescendo systolic murmur with beat-to-beat variability aids diagnosis. Multimodal imaging is critical for diagnosis and surgical planning. Prompt excision and careful perioperative management ensure durable relief and favorable long-term outcomes. TAKE-HOME MESSAGES: AMVT, although congenital, can present as LVOT obstruction, even in elderly patients. A crescendo systolic murmur with beat-to-beat variability is a clinical sign of dynamic obstruction caused by AMVT.
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Taniguchi et al. (2025) conducted a case report in Left Ventricular Outflow Tract Obstruction Due to Accessory Mitral Valve Tissue (n=1). Surgical resection was evaluated on Symptom resolution and recurrence of LVOT obstruction. Surgical resection of accessory mitral valve tissue successfully relieved left ventricular outflow tract obstruction in a 73-year-old man, who remained asymptomatic without recurrence at 3 years.
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