Hypertrophic Obstructive Cardiomyopathy and Severe Mitral Regurgitation due to Chordae Tendinae Rupture

A 60-year-old gentleman came to the cardiac emergency room of our hospital complaining of a 3-day long shortness of breath and orthopnea. The patient gave a history of prior diagnosis of hypertrophic obstructive cardiomyopathy (HOCM). Due to the existence of two jets of mitral regurgitation and the lack of full clarification of the mitral valve anatomy by transthoracic echo, the patient underwent transesophageal echocardiography study. The latter was able to detect the origin of the jets, therefore,the jet towards the posterior wall of the left atrium was caused by the SAM of the mitral valve leaflet, while the one towards the atrial septum was created by the flail posterior leaflet – medial segment (P2) – because of the chordae tendineae rupture. The patient underwent surgical operation namely myectomy according to the Morrow procedure and mitral valve replacement. He had an uneventful postoperative course