{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T10:00:11Z","timestamp":1762941611292,"version":"3.45.0"},"reference-count":7,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,10,27]]},"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:p>A woman in her thirties with severe eccentric mitral regurgitation and reduced left ventricular ejection fraction (LVEF 30\u201335%) underwent chordal-sparing mechanical mitral valve replacement (MVR) via a transseptal approach. Post-operative echocardiography revealed an echogenic mass near the mitral prosthesis, raising suspicion of a retained anterior mitral leaflet (AML) or ruptured sub-valvular structure. Due to persistent imaging concerns, she underwent a redo sternotomy and transaortic excision of the retained AML with subvalvular apparatus. Post-second surgery, the patient recovered well with improved LVEF and normal prosthetic valve function. This case highlights the rare complication of retained leaflet tissue following chordal-sparing MVR and the importance of early recognition and intervention.<\/jats:p>","DOI":"10.1136\/bcr-2025-269065","type":"journal-article","created":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:55:17Z","timestamp":1762941317000},"page":"e269065","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Retained anterior mitral leaflet mimicking mass after chordal-sparing mitral valve replacement"],"prefix":"10.1136","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4179-4428","authenticated-orcid":false,"given":"Rupendra Nath","family":"Saha","sequence":"first","affiliation":[{"name":"Cardiology, AIIMS Rishikesh, Rishikesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhanu","family":"Duggal","sequence":"additional","affiliation":[{"name":"Cardiology, AIIMS Rishikesh, Rishikesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-7626-417X","authenticated-orcid":false,"given":"Raghuraj","family":"Chawla","sequence":"additional","affiliation":[{"name":"Cardiology, AIIMS Rishikesh, Rishikesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1372-609X","authenticated-orcid":false,"given":"Shubham Singh","family":"Rawat","sequence":"additional","affiliation":[{"name":"Cardio-thoracic and Vascular surgery, AIIMS Rishikesh, Rishikesh, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,11,12]]},"reference":[{"key":"2025111201551104000_18.11.e269065.1","first-page":"401","article-title":"Effect of degenerative mitral regurgitation repair on long-term survival","volume":"374","author":"Suri","year":"2016","journal-title":"N Engl J Med"},{"key":"2025111201551104000_18.11.e269065.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(97)70383-0"},{"key":"2025111201551104000_18.11.e269065.3","doi-asserted-by":"crossref","first-page":"1384","DOI":"10.1016\/S0003-4975(00)02502-9","article-title":"Spontaneous rupture of preserved papillary muscle after mitral valve replacement with chordal preservation","volume":"72","author":"Lemke","year":"2001","journal-title":"Ann Thorac Surg"},{"key":"2025111201551104000_18.11.e269065.4","first-page":"590","article-title":"Papillary muscle rupture after chordal sparing mitral valve replacement","volume":"7","author":"Goldenberg","year":"1998","journal-title":"J Heart Valve Dis"},{"key":"2025111201551104000_18.11.e269065.5","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1016\/S0022-5223(19)38367-9","article-title":"Occlusion of Medtronic Hall mitral valve prosthesis by ruptured papillary muscle and chordae tendineae","volume":"88","author":"Trites","year":"1984","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2025111201551104000_18.11.e269065.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-4975(10)61375-6"},{"key":"2025111201551104000_18.11.e269065.7","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s12055-022-01437-9","article-title":"Long-term evaluation of TTK Chitra heart valve prosthesis - a retrospective-prospective cohort study","volume":"39","author":"Varma","year":"2023","journal-title":"Indian J Thorac Cardiovasc Surg"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-269065","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,12]],"date-time":"2025-11-12T09:55:18Z","timestamp":1762941318000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-269065"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11]]},"references-count":7,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2025,11,12]]},"published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1136\/bcr-2025-269065"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-269065","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11]]}}}