Clinical Image
Mitral Stenosis in Young Adults
Syed Aitizaz Uddin*
Department of Cardiac Surgery, Madinah Cardiac Center, Saudi Arabia
*Corresponding author: Syed Aitizaz Uddin, Department of Cardiac Surgery, Madinah Cardiac Center, Madinah, Po Box 6167, Saudi Arabia
Published: 07 Jul 2017
Cite this article as: Uddin SA. Mitral Stenosis in Young
Adults. Clin Surg. 2017; 2: 1548.
Clinical Image
In the given Figure 1 severe calcification with Fibrosis in a young adult male patient with history
of rheumatic heart disease. He had severe Mitral stenosis with moderate Mitral Regurgitation on
Preoperative Echocardiogram. The valve during surgery appeared as a solid structure which had to
be excised by cutting around its annulus with sharp dissection. Both leaflets and sub valve apparatus
had severe fibrosis with calcification. This degree of degeneration of Rheumatic valves is not seen in
the countries with access to modern health care Figure 1.
This 23 years old lady had an episode of pulmonary odema during her last pregnancy which
resulted in abortion. Echocardiogram revealed severe Mitral stenosis with abnormal looking
Mitral valve with two papillary muscles. Imaging was reported as most probably a "supra Mitral
Membrane" adherent to the Mitral valve Figure 2. During surgery the Mitral valve was found to have
one Dome like structure with a 0.5 cm slit like opening in the middle. The Chordae were attached to
the ventricular aspect of this opening and were crowded. There were two distinct papillary muscles
in normal position. A rare congenital anomaly described as "Unicuspid Mitral Valve" in literature.
The picture is an operative photograph before excising the valve.
Figure 1
Figure 1
Mitral Stenosis.
Figure 2
Figure 2
Unicuspid Mitral Valve.