Supravalvar mitral ring is a rare non-inheritable heart defect of surgical importance. This condition characterized by an abnormal bulge of atrial connective tissue in the mitral valve. Often circumferential in shape, the supravalvar ring may encroach on the orifice of the mitral valve and may adhere to the leaflets of the valve and restrict their movements. The mitral valve ring can allow normal hemodynamic flow from the left atrium to the left ventricle (LV), but often substantially impedes mitral valve influx.

Two subtypes of this abnormality have been described: "supra-mitral" variants and "intra-mitral" variants. The supra-mitral valve type is the platform fibrous membrane located directly above the mitral valve annulus and below the left atrial appendage. Not adjacent to the tip of the mitral valve. This variant usually has a normal mitral valve device. The intra-mitral valve variant is the membrane in the mitral valve tunnel that is closely adjacent to the leaflets. This subtype is associated with a high incidence of mitral valve abnormalities. These include reduced mitral valve activity, reduced wisdom teeth length, reduced papillary muscle spacing, and isolated papillary muscle or mitral annulus hypoplasia.

The intramitral type is also frequently part of the Shone complex, in which multiple levels of left heart obstruction are present, including aortic arch hypoplasia or coarctation, aortic valve stenosis, or subaortic stenosis. Supravalvar mitral stenosis can develop as an acquired lesion late after mitral annuloplasty to repair mitral regurgitation. Obstruction to mitral inflow comes from reduction in the mitral valve orifice area. When significant, a diastolic pressure difference occurs between the left atrium and left ventricle and this haemodinamic condition causes, in severe cases, pulmonary edema.

The importance of regular medical treatment to patients and their families, the need for antibiotic prophylaxis in regular medical diagnosis, restriction of excessive physical labor, dental surgery, for all infections Educate about the need for immediate attention.

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With Regards,
Jessica Lopez
Journal of Cardiac and Pulmonary Rehabilitation