Key result
Posterior mitral leaflet and chordal reconstruction using autologous pericardium with ring annuloplasty achieved competent valve closure (~8 mm coaptation) and stable function at 1 month in a 9-year-old boy.
Why the study?
Ebstein-like malformation of the mitral valve is an exceptionally rare congenital anomaly in which deficiency of functional posterior leaflet tissue causes severe mitral regurgitation and poses a major challenge for valve repair.
Does reconstruction of the posterior leaflet and chordal structures using glutaraldehyde-treated autologous pericardium combined with prosthetic ring annuloplasty restore mitral valve competence in a pediatric patient with severe mitral regurgitation due to an Ebstein-like malformation of the mitral valve?
Case Report (n=1)
No
Does reconstruction of the posterior leaflet and chordal structures using glutaraldehyde-treated autologous pericardium combined with prosthetic ring annuloplasty restore mitral valve competence in a pediatric patient with severe mitral regurgitation due to an Ebstein-like malformation of the mitral valve?
Complete reconstruction of the posterior mitral leaflet and chordae using glutaraldehyde-treated autologous pericardium combined with ring annuloplasty offers a feasible valve-preserving surgical option for pediatric Ebstein-like mitral valve malformation when the anterior leaflet apparatus is preserved.
Answers are grounded in this paper and cite their sources.
Suggests feasible valve-preserving option in rare pediatric Ebstein-like mitral regurgitation; hypothesis-generating, requiring prospective validation before broader use.
Background: Ebstein-like malformation of the mitral valve is an exceptionally rare congenital anomaly characterized by incomplete delamination and apical displacement of the posterior mitral leaflet. The resulting deficiency of functional leaflet tissue may cause severe mitral regurgitation and poses a major challenge for valve repair. Case presentation: A 9-year-old boy presented with fatigue and exertional dyspnea. Echocardiography showed severe mitral regurgitation, marked posterior leaflet hypoplasia, and left atrial enlargement. Intraoperatively, the posterior leaflet was almost completely adherent to the ventricular wall, and the posterior annulus was poorly defined, apically displaced, and dilated. The anterior leaflet and its subvalvular apparatus were preserved. The posterior leaflet and chordal structures were reconstructed using glutaraldehyde-treated autologous pericardium, followed by prosthetic ring annuloplasty. Intraoperative echocardiography demonstrated competent valve closure without mitral stenosis or systolic anterior motion. The postoperative course was uneventful, and mitral valve function remained stable at the one-month follow-up. Conclusion: Reconstruction of the posterior leaflet and chordal structures using autologous pericardium, combined with ring annuloplasty, may provide a valve-preserving option for pediatric patients with an Ebstein-like malformation of the mitral valve when the anterior leaflet and its corresponding subvalvular apparatus are adequately preserved; although long-term follow-up is required to assess durability
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Nguyen et al. (2026) conducted a case report in Ebstein-like malformation of the mitral valve with severe mitral regurgitation (n=1). Mitral valve repair with posterior leaflet and chordal reconstruction using glutaraldehyde-treated autologous pericardium and prosthetic ring annuloplasty (32-mm Edwards Physio II) was evaluated on Mitral valve competence and postoperative clinical stability at 1-month follow-up. Posterior mitral leaflet and chordal reconstruction using autologous pericardium with ring annuloplasty achieved competent valve closure (~8 mm coaptation) and stable function at 1 month in a 9-year-old boy.
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