Isolated Double-Orifice Mitral Valve With Severe Mitral Regurgitation: Successful Mitral Valve Repair.

BACKGROUND: Severe mitral regurgitation (MR) associated with isolated double-orifice mitral valve (DOMV) in adults is uncommon, and both its diagnosis and surgical management remain challenging. CASE SUMMARY: A 60-year-old woman presented with symptomatic severe MR and was scheduled for mitral valve repair. Transthoracic echocardiography suggested abnormal subvalvular morphology and demonstrated dual left ventricular inflow jets, raising suspicion for DOMV. Three-dimensional transesophageal echocardiography confirmed a complete-bridge DOMV. Intraoperatively, 2 independent parachute-like subvalvular apparatuses were identified. Mitral valve repair using artificial chordae and annuloplasty preserved the functional valve orifices, with well-controlled MR and no significant mitral stenosis at 1-year follow-up. CONCLUSION: Characteristic transthoracic echocardiography findings may raise suspicion for DOMV, whereas 3-dimensional transesophageal echocardiography remains essential for definitive anatomical assessment. Standard repair techniques with preservation of the functional valve orifices can provide satisfactory outcomes.