Anterior leaflet on the leash: unusual cause of congenital severe mitral regurgitation

Isolated-congenital mitral regurgitation is infrequently seen in adults. In its mechanism, the entire mitral apparatus or different components separately can play a role [Gallet B. Use of echocardiography in mitral regurgitation for the assessment of its mechanism and aetiology for the morphological analysis of the mitral valve. Ann Cardiol Angeiol 2003;52(2):70-7; Valdes-Cruz LM, O'Cayre R. Echocardiographic Diagnosis of Congenital Heart Disease. Philadelphia, NY: Lippincott-Raven; 1998; Carpentier A, Branchini B, Cour JC, Asfaou E, Villani M, Deloche A et al. Congenital malformations of the mitral valve in children. Pathology and surgical treatment. J Thorac Cardiovasc Surg 1976;72: 854-66]. We report a case of an unusual congenital mitral regurgitation resulting from restriction of the mitral leaflet caused by thick fibrotic tissue connecting left atrial roof and the anterior leaflet precluding sufficient coaptation. To the best of our knowledge, this pathology has never been reported before.