Mitral arcade represents a specific form of mitral valve pathology that includes the following.
1. An adequately sized mitral valve orifice
2. Short, thick, and poorly differentiated chordae with direct insertion of the anterior leaflet into the two papillary muscle heads
3. Narrow or nearly nonexistent spaces between the abnormal chordae
4. Greater differentiation of the chordae attached to the posterior papillary muscle
A hammock valve has multiple closely spaced papillary muscles with attachments from both anterior and posterior leaflets so that the primary orifice area is markedly reduced, with only limited secondary orifice area remaining. These are mostly stenotic valves.
The clinical course of isolated mitral arcade and hammock valve varies based on the degree of mitral regurgitation and stenosis. Repair may include splitting of the papillary muscles, elongation of chordae, thinning of MV leaflets and commisuroplasty.