Isolated congenital cleft mitral valve leaflet: a rare cause of refractory cardiogenic shock complicating acute myocardial infarction

Abstract We report a unique presentation of isolated congenital cleft mitral valve complicating cardiogenic shock from acute myocardial infarction. Isolated is an uncommon diagnosis that can have significant clinical implications, especially if not recognized in patients presenting to the catheterization lab with infarction and shock. A review this rare including options timing therapeutic interventions, which include MitraClip, important for publication. The case patient who presented anterior ST elevation Despite early coronary revascularization conventional support, refractory ensued requiring mechanical circulatory support escalation Veno-arterial extracorporeal membrane oxygenation. Subsequently, left ventriculography revealed massively dilated atrium severe regurgitation raising concerns complication. was taken operating room possible surgery, but preoperative transesophageal echocardiogram posterior valve. Since had stabilized on emergent surgery deferred. successfully recovered during index hospitalization discharged guideline directed medical therapy. In conclusion, often be underrecognized without comprehensive 3-dimensional echocardiography evaluation. If diagnosed regurgitation, surgical treatment results good outcomes preservation LV systolic function. Percutaneous correction CMVL MitraClip has been described may offer alternative approach high risk patients.