CONGENITAL MITRAL STENOSIS RESULTING FROM ANOMALOUS ARCADE AND OBSTRUCTING PAPILLARY MUSCLES - REPORT OF CORRECTION BY USE OF BALL VALVE PROSTHESIS

Successful replacement of a mitral valve with a ball valve prosthesis in a 10 month old male infant is described. The resected congenitally stenotic mitral valve showed the obstructing mechanism to be related to (1) an arcade-like thickening of the line of closure of the anterior mitral leaflet, extending between the apexes of the anterolateral and the posteromedial papillary muscles, and (2) prominent papillary muscles that crowded the subvalvar area in the left ventricular inflow tract. Neither closed mitral commissurotomy nor open valvuloplasty seemed adequate to relieve this obstruction. As a consequence, replacement of the mitral valve by a ball valve prosthesis was carried out. Thirteen months after operation the patient was well. It is recognized that progressively larger prosthetic replacements may be needed as the infant grows. © 1969.