Double orifice mitral valve in rheumatic heart disease.

A 55-year-old female, presented to our outpatient department with complaints of dyspnea on exertion, NYHA grade II for 7 years, which had progressed to NYHA Grade III in the past 6 months. An echocardiogram done showed severe mitral stenosis with mitral valve fused in the middle to create an appearance of 2 separate valves (complete bridge type) with 2 separate turbulent jets of flow across these valves. No other congenital anomaly was seen. Due to presence of severe subvalvular disease, she was sent for elective mitral valve replacement. This case demonstrates that a careful analysis of the subvalvular apparatus of the mitral valve is needed before making a decision for definitive treatment of this condition.