{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,4]],"date-time":"2026-07-04T04:31:23Z","timestamp":1783139483514,"version":"3.54.6"},"reference-count":10,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,6,3]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:p>There are nine published reports of trileaflet mitral valves globally. As such their implication on health outcomes and associations with other disease is uncertain. This case describes a 62-year-old man presenting with exertional dyspnoea and hypertension. It describes an early misdiagnosis of hypertrophic cardiomyopathy and highlights that clinicians should be alerted in cases of very high left ventricular outflow gradients in the presence of eccentric mitral regurgitation (MR). Here the MR was caused by a rare congenital deformity whereby a deep cleft in the posterior leaflet resulted in a tricuspid appearance. We present the natural disease course of a trileaflet mitral valve and without intervention over 13 years from symptom onset to the development of severe MR.<\/jats:p>","DOI":"10.1136\/bcr-2018-229106","type":"journal-article","created":{"date-parts":[[2019,6,19]],"date-time":"2019-06-19T06:45:15Z","timestamp":1560926715000},"page":"e229106","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Case of trileaflet mitral valve: an important differential for non-classical intracavitary gradient in suspected hypertrophic cardiomyopathy"],"prefix":"10.1136","volume":"12","author":[{"given":"Joseph","family":"Barker","sequence":"first","affiliation":[{"name":"Department of Cardiology, Hawkes Bay Hospital, Hastings, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Silverwood","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hawkes Bay Hospital, Hastings, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Gerber","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hawkes Bay Hospital, Hastings, New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,18]]},"reference":[{"key":"2025082703581023000_12.6.e229106.1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq380"},{"key":"2025082703581023000_12.6.e229106.2","doi-asserted-by":"crossref","first-page":"513","DOI":"10.1016\/j.amjcard.2017.11.018","article-title":"The Trileaflet Mitral Valve","volume":"121","author":"Chui","year":"2018","journal-title":"Am J Cardiol"},{"key":"2025082703581023000_12.6.e229106.3","doi-asserted-by":"crossref","first-page":"1435","DOI":"10.1111\/echo.12938","article-title":"Trileaflet Mitral Valve with Three Papillary Muscles Associated with Hypertrophic Cardiomyopathy: A Novel Case","volume":"32","author":"Rosanio","year":"2015","journal-title":"Echocardiography"},{"key":"2025082703581023000_12.6.e229106.4","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jev034"},{"key":"2025082703581023000_12.6.e229106.5","doi-asserted-by":"crossref","first-page":"549","DOI":"10.1016\/j.ijcard.2015.08.141","article-title":"Tri-leaflet mitral valve variant of hypertrophic obstructive cardiomyopathy: Comprehensive assessment with 3-D transesophageal echocardiography","volume":"201","author":"Butler","year":"2015","journal-title":"Int J Cardiol"},{"key":"2025082703581023000_12.6.e229106.6","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehu024"},{"key":"2025082703581023000_12.6.e229106.7","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1111\/echo.13258","article-title":"Isolated Cleft of the Posterior Mitral Valve Leaflet: The Value of 3DTEE in the Evaluation of Mitral Valve Anatomy","volume":"33","author":"Guerreiro","year":"2016","journal-title":"Echocardiography"},{"key":"2025082703581023000_12.6.e229106.8","first-page":"589","article-title":"Trileaflet Mitral Valve Treated with the MitraClip\u00ae System","volume":"26","author":"Rodr\u00edguez-Santamarta","year":"2017","journal-title":"J Heart Valve Dis"},{"key":"2025082703581023000_12.6.e229106.9","doi-asserted-by":"crossref","first-page":"355","DOI":"10.4244\/EIJY14M07_05","article-title":"MitraClip repair of a \"trileaflet\" regurgitant mitral valve","volume":"11","author":"Freixa","year":"2015","journal-title":"EuroIntervention"},{"key":"2025082703581023000_12.6.e229106.10","doi-asserted-by":"publisher","DOI":"10.1093\/ehjci\/jeu154"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-229106","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:58:17Z","timestamp":1756292297000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-229106"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6]]},"references-count":10,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2019,6,18]]},"published-print":{"date-parts":[[2019,6]]}},"alternative-id":["10.1136\/bcr-2018-229106"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-229106","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6]]}}}