Valve-sparing surgery for isolated cleft mitral valve complicated by endocarditis in a child.

A 12-year-old girl presented with an isolated cleft mitral valve complicated by infective endocarditis that was confined to the medial part of the cleft anterior leaflet. An innovative valve-sparing surgery was applied whereby the destroyed part of the leaflet was removed. The corresponding anterior annulus was plicated by approximation of the base of the cleft to the posteromedial commissure. The ‘cleft’ edge of AML was then sutured to the plicated annulus and to P3 at the level of the posteromedial commissure. The reconstructed valve was fully functional, and showed trivial regurgitation and an absence of stenosis for up to two years postoperatively.