Intravalvular mitral membrane causing severe obstruction at the mitral valve in a young man

A man in his 30s presented with worsening shortness of breath for the last 6 months. He had a history of surgical repair of coarctation of the aorta 15 years ago. Examination revealed a mid-diastolic murmur at the mitral area. On transthoracic echocardiography, there was suspicion of intravalvular mitral membrane causing severe obstruction, which was confirmed on transoesophageal echocardiography and cardiac CT angiography. The patient underwent resection of the intravalvular mitral membrane and replacement of the mitral valve by a mechanical prosthesis. The patient responded well to surgery with resolution of symptoms.