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Mitral Valve Aneurysm Due to Severe Aortic Valve Regurgitation

1999; Lippincott Williams & Wilkins; Volume: 100; Issue: 12 Linguagem: Inglês

10.1161/01.cir.100.12.e53

1524-4539

Tung H. Cai, Joe M. Moody, Edward Y. Sako,

Kawasaki Disease and Coronary Complications

HomeCirculationVol. 100, No. 12Mitral Valve Aneurysm Due to Severe Aortic Valve Regurgitation Free AccessOtherPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyRedditDiggEmail Jump toFree AccessOtherPDF/EPUBMitral Valve Aneurysm Due to Severe Aortic Valve Regurgitation Tung H. Cai, Joe M. MoodyJr, and Edward Y. Sako Tung H. CaiTung H. Cai From the Divisions of Thoracic Surgery (T.H.C., E.Y.S.) and Cardiology (J.M.M.), Audie L. Murphy VA Hospital, University of Texas Health Science Center at San Antonio. , Joe M. MoodyJrJoe M. MoodyJr From the Divisions of Thoracic Surgery (T.H.C., E.Y.S.) and Cardiology (J.M.M.), Audie L. Murphy VA Hospital, University of Texas Health Science Center at San Antonio. and Edward Y. SakoEdward Y. Sako From the Divisions of Thoracic Surgery (T.H.C., E.Y.S.) and Cardiology (J.M.M.), Audie L. Murphy VA Hospital, University of Texas Health Science Center at San Antonio. Originally published21 Sep 1999https://doi.org/10.1161/01.CIR.100.12.e53Circulation. 1999;100:e53–e56A 33-year-old man presented to the hospital with shortness of breath and chest pain. He was subsequently diagnosed with Streptococcus mitis endocarditis involving the aortic valve. The initial echocardiogram revealed moderate aortic valve regurgitation and a normal mitral valve without regurgitation. The patient was treated with afterload reduction and antibiotics. Blood cultures were negative within 2 days after initiation of antibiotics. He returned to the hospital 1 month later with worsening symptoms, and a repeat echocardiogram showed worsening aortic valve regurgitation. A mitral valve aneurysm was also visualized, with moderate mitral valve regurgitation. The aneurysm was located on the anterior leaflet near the septal commissure and was due to regurgitant blood flow from the aortic valve. Because of worsening of aortic valve regurgitation and refractory symptoms, the patient was referred for surgery. The aortic valve was replaced with a No. 23 St Jude mechanical prosthesis. The mitral valve aneurysm was resected and the defect in the anterior leaflet primarily repaired. A No. 30 Baxter annuloplasty ring was also placed. Pathological evaluation of the aneurysm revealed chronic inflammation without evidence of active endocarditis. The patient recovered uneventfully and was discharged home with anticoagulation. The editor of Images in Cardiovascular Medicine is Hugh A. McAllister, Jr, MD, Chief, Department of Pathology, St Luke's Episcopal Hospital and Texas Heart Institute, and Clinical Professor of Pathology, University of Texas Medical School and Baylor College of Medicine.Circulation encourages readers to submit cardiovascular images to Dr Hugh A. McAllister, Jr, St Luke's Episcopal Hospital and Texas Heart Institute, 6720 Bertner Ave, MC1-267, Houston, TX 77030.Download figureDownload PowerPoint Figure 1. Initial transesophageal echocardiography showing intact mitral valve. LA indicates left atrium; LV, left ventricle.Download figureDownload PowerPoint Figure 2. Transesophageal echocardiography at second presentation revealing aneurysm in anterior leaflet. MVA indicates mitral valve aneurysm; other abbreviations as in Figure 1.Download figureDownload PowerPoint Figure 3. Color Doppler of Figure 2 showing regurgitant aortic insufficiency jet hitting mitral valve. Abbreviations as in previous figures.Download figureDownload PowerPoint Figure 4. Intraoperative photograph of mitral valve with aneurysm (MVA).Download figureDownload PowerPoint Figure 5. Intraoperative photograph of mitral valve after repair.Download figureDownload PowerPoint Figure 6. Intraoperative TEE showing repaired mitral valve with annuloplasty ring in place. Abbreviations as in Figure 1.FootnotesCorrespondence to Edward Y. Sako, MD, PhD, Division of Thoracic Surgery, University of Texas Health Science Center, 7703 Floyd Curl Dr, San Antonio, TX 78284-7841. Previous Back to top Next FiguresReferencesRelatedDetails September 21, 1999Vol 100, Issue 12Article InformationMetrics Download: 86 Copyright © 1999 by American Heart Associationhttps://doi.org/10.1161/01.CIR.100.12.e53 Originally publishedSeptember 21, 1999 PDF download