Pseudoaneurysm of Mitral-Aortic Intervalvular Fibrosa Following Regurgitation of Congenital Bicuspid Aortic Valve in a 63-year-Old Patient: A Case Report

Chunling Jiang,Wei Cao,Yi Yang,Hong Chang,Li Zhou

doi:10.15436/2377-1364.17.077

Abstract

Pseudoaneurysm of mitral aortic intervalvular fibrosa (P-MAIVF) is a rare but potentially catastrophic condition. P-MAIVF is often associated with infective endocarditis, aortic valve surgery or chest trauma. However, P-MAIVF attributed to congenital abnormality is even rarer. Here, we present a case of chronic, non-infective P-MAIVF associated with congenital bicuspid aortic valve. In the present case, there is neither a history nor sign suggesting infective endocarditis, nor positive blood or tissue culture results. The preoperative Transesophageal echocardiography (TEE) examination detected P-MAIVF with severe regurgitation of bicuspid aortic valve, which was misdiagnosed as pure bicuspid aortic valve regurgitation by transthoracic echocardiogram (TTE). Consequently, TEE provides valuable information on the diagnosis and choice of surgery for the patient.

Highlights

Pseudoaneurysm of mitral aortic intervalvular fibrosa (P-MAIVF), located between the mitral and aortic valves, is an uncommon but potentially catastrophic condition[1]
The MAIVF is an membranous structure located adjacent to the left ventricular outflow tract between the aortic and mitral valve providing functional and anatomical integrity5
Since the MAIVF is relatively avascular, it becomes more prone to infection, trauma or pseudoaneurysm formation[5,6]

Summary

Introduction

Pseudoaneurysm of mitral aortic intervalvular fibrosa (P-MAIVF), located between the mitral and aortic valves, is an uncommon but potentially catastrophic condition[1]. P-MAIVF is often associated with infective endocarditis, aortic valve surgery or chest trauma[2,3]. Congenital heart diseases, such as bicuspid aortic valve, ventricular septal defect or patent ductus arteriosus, are rare causative factors of P-MAIVF[4,5]. We present a case of congenital P-MAIVF in a 63-year-old patient with severe regurgitation of bicuspid aortic valve detected by preoperative trans-oesophageal echocardiography (TEE).

Results

Conclusion