Dr. Usman's Cardiology Notes

  Parachute mitral valve and supramitral ring are both rare congenital anomalies of the mitral valve apparatus, often associated with left-sided obstructive lesions and sometimes coexisting as part of Shone’s complex. They share the common feature of producing left atrioventricular inflow obstruction, but their anatomical basis and clinical implications differ. Parachute mitral valve is characterized by the insertion of all, or most, of the chordae tendineae into a single papillary muscle instead of the normal two. In some cases, there may be two papillary muscles present but one is underdeveloped and functionally all chordae converge to the dominant one. This abnormal arrangement causes restricted opening of the mitral valve leaflets, leading to varying degrees of mitral inflow obstruction. The severity of obstruction depends on the degree of chordal crowding and leaflet tethering. Clinically, parachute mitral valve can manifest in childhood with symptoms of pulmonary congestion, ...