title: Isolated congenital anterior mitral leaflet cleft: a rare cause of mitral insufficiency.
abstract: OBJECTIVE
  Isolated cleft of the anterior mitral leaflet is a rare cause of mitral insufficiency. Although an established entity, due to its rarity the exact anatomic diagnosis is difficult to establish unless sought specifically.
  
  
  METHODS
  Four patients (age range: 16 to 26 years) with isolated cleft of the anterior mitral leaflet were treated at the authors' institute. Clinical symptoms were typical of mitral insufficiency; the exact anatomic diagnosis was not established preoperatively in any patient. The cleft was directly sutured in all four patients and additional annuloplasty was performed in three.
  
  
  RESULTS
  Postoperative echocardiography confirmed satisfactory results. After a mean follow up of 46.7 months (range: 3 to 84 months), one patient had mild mitral insufficiency and the remaining patients had no mitral regurgitation.
  
  
  CONCLUSIONS
  In severe mitral insufficiency with no obvious mitral valve pathology and an intact atrial septum, a cleft of the anterior mitral leaflet should be sought. Repair of the cleft can restore normal mitral valve function.
authors: Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi.
authors: S R
authors: SR
authors: Mohanty
authors: S K
authors: SK
authors: Choudhary
authors: S
authors: S
authors: Ramamurthy
authors: A S
authors: AS
authors: Kumar
mesh_terms: D000293:Adolescent; D000328:Adult; D004452:Echocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000002:abnormalities* / Q000601:surgery; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging / Q000209:etiology*; D020127:Recovery of Function