Intraoperative Three-Dimensional Transesophageal Echocardiography: Reconstruction of Mitral Valve Ring Abscess

Abstract

A CARDIAC pseudoaneurysm refers to a contained rupture of the myocardium. 1 Mathur M Gupta S. Cardiac pseudoaneurysm- a death defying entity. J Clin Diagn Res. 2016; 10: TD06-TD07 PubMed Google Scholar The left ventricle is the most commonly affected site for pseudoaneurysm formation as a complication after myocardial infarction. 2 Li X Wang Y Wang D et al. The evolution of left ventricular pseudoaneurysm from the rupture of left ventricular free wall following acute myocardial infarction: A case report. BMC Cardiovasc Disord. 2020; 20: 5 Crossref PubMed Scopus (2) Google Scholar However, pseudoaneurysms also can arise in other sites, including the atria, owing to various causes such as infection or trauma. 3 Wygant CM Cohle SD. Fatal rupture of pseudoaneurysm following angioplasty. Cardiovasc Pathol. 2021; 50107268 Crossref PubMed Scopus (2) Google Scholar Mitral valve ring abscess (MVRA) with associated left atrial pseudoaneurysm is a rare complication of infective endocarditis (IE). 4 Ranjan R Lawrence T. Cardiac tamponade following mitral valve replacement for active infective endocarditis with ring abscess. Case Rep Cardiol. 2015; 2015790213 PubMed Google Scholar Once a diagnosis of valvular endocarditis is made, time to surgical intervention when medical management is deemed insufficient is important because delayed intervention may increase the complexity of the surgical presentation. 1 Mathur M Gupta S. Cardiac pseudoaneurysm- a death defying entity. J Clin Diagn Res. 2016; 10: TD06-TD07 PubMed Google Scholar , 2 Li X Wang Y Wang D et al. The evolution of left ventricular pseudoaneurysm from the rupture of left ventricular free wall following acute myocardial infarction: A case report. BMC Cardiovasc Disord. 2020; 20: 5 Crossref PubMed Scopus (2) Google Scholar , 3 Wygant CM Cohle SD. Fatal rupture of pseudoaneurysm following angioplasty. Cardiovasc Pathol. 2021; 50107268 Crossref PubMed Scopus (2) Google Scholar , 4 Ranjan R Lawrence T. Cardiac tamponade following mitral valve replacement for active infective endocarditis with ring abscess. Case Rep Cardiol. 2015; 2015790213 PubMed Google Scholar The authors present a case of mitral valve endocarditis with subsequent breakdown of the posteromedial annulus creating an MVRA with aneurysmal qualities in the setting of a high-velocity regurgitant jet.