A cleft valve is a rare, congenital heart defect characterized by a split or opening in one of the leaflets of the mitral valve (most commonly) or, less frequently, the tricuspid valve.
Here's a breakdown of the condition:
Mitral Valve Cleft
- Definition: A cleft in the mitral valve leaflet, most often the anterior leaflet. This cleft prevents the valve from closing properly, leading to mitral regurgitation (blood leaking backwards through the valve).
- Congenital Nature: This condition is present at birth.
- Non-Syndromic vs. Syndromic: While sometimes an isolated anomaly, cleft mitral valves can be associated with other congenital heart defects or genetic syndromes, such as Down syndrome or atrioventricular canal defect. When it occurs on its own, it is considered non-syndromic.
- Functional Impact: The cleft disrupts the normal function of the mitral valve. During ventricular systole (contraction), the valve leaflets are supposed to close tightly to prevent backflow of blood from the left ventricle into the left atrium. A cleft interferes with this closure, causing regurgitation.
- Appearance: Affected leaflets are often thickened and distorted.
Tricuspid Valve Cleft
- Rarer Occurrence: Clefts in the tricuspid valve are less common than those in the mitral valve.
- Similar Mechanism: Similar to mitral valve clefts, a tricuspid valve cleft leads to tricuspid regurgitation, where blood leaks backwards from the right ventricle into the right atrium.
Clinical Significance and Treatment
- Symptoms: Symptoms can vary depending on the severity of the regurgitation. Mild cases may be asymptomatic, while severe cases can lead to heart failure. Symptoms may include shortness of breath, fatigue, and swelling in the legs and ankles.
- Diagnosis: Echocardiography is the primary diagnostic tool. It allows visualization of the valve structure and assessment of the severity of regurgitation.
- Treatment: The treatment approach depends on the severity of the condition. Mild cases may only require monitoring. More severe cases often require surgical repair of the valve.
Summary
In essence, a cleft valve involves an abnormal opening or split in a valve leaflet, most commonly affecting the mitral valve, leading to valve regurgitation and potentially requiring surgical intervention.
