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A 75-year-old gentleman, who had undergone CABG surgery 18 years previously, reported increasing dyspnoea. Transthoracic echocardiography revealed a posteriorly directed jet of moderate mitral regurgitation (MR), reported to be of functional origin (Carpentier classification IIIb). Transoesophageal echocardiography revealed an unexpected structure traversing the left atrium (LA), attaching to the anterior mitral leaflet ( Panel A1 ). Posterior leaflet motion was …

Left atrial fibrous band, an unexpected mechanism of mitral regurgitation