Repair of a duplicate mitral valve in a patient with ascending aortic aneurysm and bicuspid aortic valve.

We present the case of a 48-year-old man presenting to the emergency department with acute onset of chest pain radiating to the back in the setting of a known ascending aortic aneurysm. Preoperative echocardiography revealed an incompetent duplicate mitral valve, with a medially directed eccentric 3+ jet of mitral regurgitation, and a bicuspid aortic valve. The patient was scheduled for aortic root and valve replacement with concurrent mitral valve repair. Intraoperative examination revealed an incompetent duplicate mitral valve separated from the physiologic mitral valve by a band of interatrial tissue. Successful repair was undertaken by oversewing the mitral valve. Postoperative echocardiography allowed for evaluation of this unique repair, which revealed no evidence of further mitral regurgitation and confirmed a successful repair of the mitral regurgitation without any need for an implantable device. Our goal is that this case and its positive treatment outcome, along with our three-dimensional echocardiographic images correlated with the intraoperative findings and photographs, will further the understanding of the diagnosis and treatment of this rare condition.