Left Ventricular Outflow Tract Obstruction from Preserved Leaflet after Mitral Valve Replacement.

Left ventricular outflow tract obstruction (LVOTO) can be caused by multiple factors. One of rare causes of LVOTO is preserved anterior mitral valve leaflet and chordal apparatus after mitral valve replacement. Here, we describe a case of a patient who presented with worsening chronic congestive heart failure secondary to LVOTO from systolic anterior motion of residual native anterior mitral leaflet. This was surgically corrected by excision of anterior leaflet and chordal apparatus through the aortic root.