Parachute mitral valve and Pacman deformity of the ventricular septum in a middle-aged male

Parachute mitral valve and Pacman heart (incomplete muscular ventricular septal defect) are rare congenital deformities usually reported in infants and children. Very few adult patients with these anomalies are reported but the association of the two has not been described. This report describes a 56-year-old male with exertional dyspnea who was detected to have moderately severe mitral regurgitation and mitral stenosis. Typical parachute deformity of the mitral valve with a reduced opening and common attachment of all the chordae to a single posteromedial papillary muscle was evident. The chordae were elongated, lax, and redundant, which is atypical for this anomaly. Incidentally, detected aneurysm of the basal muscular interventricular septum (Pacman deformity or incomplete triangular septal defect) was also present.