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Figueroa-Casanova R, Saavedra-Henao JD, Figueroa-Laverde JS, Beltrán-Gonzales DA, Labrador-Rosales JG, Eslait-Olaciregui S, Pérez Rivera CJ. Fistula of the mitral-aortic intervalvular fibrosa in a patient with bacterial endocarditis: a case report and systematic literature review. J Cardiothorac Surg 2024; 19:300. [PMID: 38807242 PMCID: PMC11131286 DOI: 10.1186/s13019-024-02736-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/29/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND A fistulous tract in the mitro-aortic intervalvular fibrosa (MAIVF) is a rare entity, which presents as a complication of endocarditis or surgical trauma. Generally, it is associated to a pseudoaneurysm of the MAIVF (p-MAIVF) or aortic abscesses. MAIVF fistulas could potentially lead to devastating complications and a high mortality rate. This condition is managed surgically, either by a percutaneous closure or an open surgical approach. Herein we report the complex case of a patient with a MAIVF fistula secondary to bacterial endocarditis. Further clinical deterioration was caused by severe aortic valve insufficiency and hemodynamic compromise, requiring surgical intervention. CASE PRESENTATION A 74-year-old male patient was admitted to a primary care center with complaints of malaise, asthenia, adynamia, hyporexia, and lower limb edema over the past eight days. His past medical history is positive for arterial hypertension and being monorenal. A transesophageal echocardiogram (TEE) was performed, exhibiting a 56% left ventricle ejection fraction (LVEF) and complicated aortic valve endocarditis. Surgical management through an open approach included vegetation resection, valve replacement, and closure of the MAIVF fistula. After completing antibiotic therapy, the patient was discharged without complications. During postoperative follow-up, the patient remained asymptomatic, and the control echocardiogram showed no signs of MAIVF fistula.4. CONCLUSIONS The clinical case of a patient with a MAIVF fistula secondary to endocarditis by Streptococcus Anginous was presented. The fistulous tract was not associated to p-MAIVF or aortic abscess, findings which further deteriorate the patient's condition and increase the likelihood of fatality. This case reinforces the importance of a prompt diagnosis through cardiac imaging and timely surgical closure of the defect.
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Varga A, Tilea I, Tatar CM, Iancu DG, Jiga MA, Dumbrava RA, Pop M, Suciu H. Native Aortic Valve Endocarditis Complicated by Splenic Infarction and Giant Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm-A Case Report and Brief Review of the Literature. Diagnostics (Basel) 2021; 11:diagnostics11020251. [PMID: 33562151 PMCID: PMC7914780 DOI: 10.3390/diagnostics11020251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Revised: 01/27/2021] [Accepted: 02/03/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is an unusual complication related to various injuries or conditions which involve the mitro-aortic region; it communicates with the left ventricular outflow tract and is associated with a high-risk of redoubtable complications or sudden death. The cerebral and splenic localizations are frequently seen as manifestations of systemic embolism in infective endocarditis. Currently, there are no specific recommendations related to the diagnosis, management, treatment, or further evolution of patients with P-MAIVF and concomitant splenic infarction. This paper presents the case of a 43-year-old Caucasian woman with a late diagnosis of mixed bicuspid aortic valve disease, affected by an under-detected and undertreated episode of infective endocarditis leading to asymptomatic P-MAIVF. Prime clinical and imagistic diagnosis of splenic infarction indicated further extended investigations were required to clarify the source of embolism. Methods: Integrated multimodality imaging techniques confirmed the unexpected diagnosis of P-MAIVF. Results: The case had a fatal outcome following an uncomplicated yet laborious cardiac surgery. Patient death was attributed to a malignant ventricular arrhythmia. Conclusion: The present case raises awareness by highlighting an unexplained and unexpected splenic infarction association with P-MAIVF as a result of infective endocarditis related to mixed bicuspid aortic valve disease.
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Affiliation(s)
- Andreea Varga
- Department ME2, Faculty of Medicine in English, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Department of Cardiology II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania;
| | - Ioan Tilea
- Department of Cardiology II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania;
- Department M4, Clinical Sciences, Faculty of Medicine, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Cristina Maria Tatar
- Department M4, Clinical Sciences, Faculty of Medicine, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
- Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania; (D.G.I.); (M.A.J.); (R.A.D.)
- Correspondence: ; Tel.: +4-0744252037
| | - Dragos Gabriel Iancu
- Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania; (D.G.I.); (M.A.J.); (R.A.D.)
- Doctoral School, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Maria Andrada Jiga
- Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania; (D.G.I.); (M.A.J.); (R.A.D.)
- Doctoral School, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Robert Adrian Dumbrava
- Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania; (D.G.I.); (M.A.J.); (R.A.D.)
- Doctoral School, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania
| | - Marian Pop
- Department ME1, Faculty of Medicine in English, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Department of Radiology and Medical Imaging, The Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania
| | - Horatiu Suciu
- Department M3, Clinical and Surgery Sciences, Faculty of Medicine, “G. E. Palade” University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Cardiac Surgery Clinic, The Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania
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Boi A, Garau G, Rossi A, Lixi G, Armandi L, Fele GS, Cossa S, Matta G, Manconi M, Sanna F, Loi B. Mitro-aortic fibrosa pseudoaneurysm and concomitant aortic stenosis: How to kill two birds with a stone. J Card Surg 2020; 35:2414-2417. [PMID: 32652709 DOI: 10.1111/jocs.14807] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Pseudoaneurysm of mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare acquired malformation of the mitral-aortic intervalvular area. It appears as a pulsatile cavity in the mitral-aortic junction communicating with the left ventricular outflow tract. P-MAIVF has been reported as a complication of aortic and mitral valve surgery, infective endocarditis, and thoracic trauma. It is associated with life-threatening complications. The recommended treatment is surgery, however, conservative therapy is an alternative approach for high-risk patients or when surgical treatment is refused. We describe a successfully exclusion of a P-MAIVF by transapical transcatheter aortic valve implantation in a patient with concomitant severe aortic stenosis.
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Affiliation(s)
- Alberto Boi
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Giovanni Garau
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Angelica Rossi
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Giovanni Lixi
- Division of Cardiac Surgery, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Laura Armandi
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | | | - Stefano Cossa
- Department of Radiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Gildo Matta
- Department of Radiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Manlio Manconi
- Department of Cardiac Anesthesia, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Francesco Sanna
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
| | - Bruno Loi
- Interventional Cardiology, Azienda Ospedaliera Brotzu, Cagliari, Sardinia, Italy
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Pseudoaneurysm of the Mitral-Aortic Fibrosa in the Absence of Valvulitis. AMERICAN JOURNAL OF MEDICAL CASE REPORTS 2020; 8:478-480. [PMID: 32968694 PMCID: PMC7508470 DOI: 10.12691/ajmcr-8-12-12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The mitral-aortic intervalvular fibrosa (MAIVF) is the thin avascular fibrous structure located between the left side of the non-coronary cusp, the left coronary cusp and the anterior mitral leaflet. MAIVF pseudoaneurysm typically results as a complication of endocarditis, aortic valve surgery or chest trauma. We present a case of an incidental MAIF pseudoaneurysm in a 68-year female with a history of rheumatic fever without involvement of the mitral apparatus. We also discuss the presentation, evaluation and management of this rather rare valvular disorder.
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Muretti M, Elmahdy W, Ttofi I, Mozalbat D, Murphy M, Asimakopoulos G, Rosendahl U. Surgical Repair of Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm in a High-Risk Patient 13 Years after Aortic Root Replacement. Tex Heart Inst J 2019; 46:147-150. [PMID: 31236084 DOI: 10.14503/thij-17-6493] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Pseudoaneurysms of the mitral-aortic intervalvular fibrosa are rare complications that can develop after mitral or aortic valve surgery, endocarditis, or Takayasu arteritis. The optimal timing of surgery to avoid potentially life-threatening complications of pseudoaneurysms has not been established, and watchful waiting has been adopted in specific situations. We describe the case of a 50-year-old man in whom a pseudoaneurysm of the mitral-aortic intervalvular fibrosa developed after aortic root replacement with a homograft. After 13 years of watchful waiting, reoperation was deemed necessary because the pseudoaneurysm had grown to 48 mm and the aortic regurgitation caused by the degenerated homograft had become severe. This case highlights the need for increased awareness of mitral-aortic intervalvular fibrosa pseudoaneurysms and their management.
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6
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Aneurysm of mitral-aortic intervalvular fibrosa—a review. Indian J Thorac Cardiovasc Surg 2017. [DOI: 10.1007/s12055-017-0504-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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7
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Han J, He Y, Gu X, Sun L, Zhao Y, Liu W, Zhang Y, Yang X, Li Y. Echocardiographic Diagnosis and Outcome of Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa: Results of a Single-Center Experience in Beijing. Medicine (Baltimore) 2016; 95:e3116. [PMID: 26986160 PMCID: PMC4839941 DOI: 10.1097/md.0000000000003116] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare but potentially fatal entity. Early diagnosis and surgical treatment are particularly important to decrease risk of mortality. The purpose of this study was to explore the echocardiographic characteristics and outcome of P-MAIVF and to evaluate the potential application of three-dimensional (3D) echocardiography in the evaluation of P-MAIVF. Clinical and echocardiographic characteristics were retrospectively evaluated in 9 patients with P-MAIVF, 5 of them assessed by 3D echocardiography. P-MAIVF was identified on echocardiography and located in the posterior aspect of the aortic root, expanding in systole and collapsing in diastole. Of the 9 cases examined, 8 were associated with endocarditis and 1 was caused by radio frequency catheter ablation of atrial fibrillation. Five cases were associated with bicuspid aortic valve, and rupture of P-MAIVF was identified in 3 patients. The morphology of P-MAIVF was clearly demonstrated on 3D echocardiography in 5 cases. In conclusion, echocardiography provides a useful tool in the diagnosis of P-MAIVF. Color Doppler flow imaging can ease identification of the ostium in cases of ruptured pseudoaneurysms. Three-dimensional echocardiography shows the relationship between P-MAIVF and the adjacent anatomic structures.
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Affiliation(s)
- Jiancheng Han
- From the Department of Ultrasound (JH, YH, XG, LS, YZ, WL, YZ, XY), Beijing Anzhen Hospital, Capital Medical University, Beijing Key Laboratory of Maternal-Fetus Medicine in Fetal Heart Disease, Chaoyang, Beijing, PR China; and Department of General Surgery and The Center for Fetal Research (YL), The Children's Hospital of Philadelphia, Philadelphia, PA
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Pseudoaneurysm of the mitral-aortic intervalvular fibrosa. A new comprehensive review. Herz 2014; 40 Suppl 2:182-9. [PMID: 25468033 DOI: 10.1007/s00059-014-4185-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Revised: 10/13/2014] [Accepted: 11/02/2014] [Indexed: 10/24/2022]
Abstract
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is an infrequent but potentially life-threatening condition. Both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) can detect P-MAIVF with sensitivity rates of 43 and 90 %, respectively. The typical finding of echocardiography is a pulsatile echo-free sac that expands in systole and collapses in diastole. Our review comprises 166 patients with P-MAIVF, including eight cases in our hospital and 158 cases from the literature. P-MAIVF is often associated with infection or surgical trauma. While it is likely to maintain an asymptomatic course, symptoms of shortness of breath, heart failure, valvular disease, chest pain, endocarditis, and cerebrovascular events are common clinical presentations. The recommended treatment is surgery. However, conservative therapy is an alternative approach for high-risk patients or when surgical treatment is refused. With the increasing incidence of cardiac surgery and infective endocarditis, a likely increment in the new diagnosis of pseudoaneurysm is expected.
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9
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Abstract
OBJECTIVES This publication aims to report the cases of four children with pseudoaneurysm of the mitral-aortic intervalvular fibrosa and carry out a review of the literature. BACKGROUND Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a very rare anomaly in children. It can be either congenital or acquired, namely, after bacterial endocarditis or cardiac trauma. This pathology does not usually cause specific symptoms but its outcome may be potentially fatal. METHODS We report the cases of four patients presenting with pseudoaneurysm of the mitral-aortic intervalvular fibrosa, referred for treatment in a paediatric cardiology clinic. Patient clinical notes were retrospectively reviewed for aetiology, clinical presentation, diagnostic work-up, surgical treatment, and follow-up. Literature on the subject was extensively reviewed. RESULTS In three patients, pseudoaneurysm of the mitral-aortic intervalvular fibrosa was acquired, being secondary to bacterial endocarditis in two cases and establishing after mitral surgery in another case. The remaining patient had a "congenital" aetiology - no other cause could be traced. The diagnosis was achieved by transthoracic echocardiography for all patients, and confirmed in all by trans-oesophageal echocardiography, to better define morphological details and to access flow into the aneurysmal formation. All patients were submitted to corrective cardiac surgery. Of the patients, three survived and were cured by surgery, staying asymptomatic, and one died after repeated interventions, for persistent endocarditis. CONCLUSIONS Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a rare but potentially fatal anomaly. In our experience, surgical cure was achieved for the majority of the cases, except for a case for which infection could not be locally eradicated, leading to multiple reinterventions.
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Xie M, Li Y, Cheng TO, Wang X, Lu Q, He L, Fu M. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa. Int J Cardiol 2013; 166:2-7. [DOI: 10.1016/j.ijcard.2012.03.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2012] [Accepted: 03/04/2012] [Indexed: 01/08/2023]
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Fazlinezhad A, Fatehi H, Tabaee S, Alavi M, Hoseini L, Yousefzadeh H. Pseudoaneurysm of mitro-aortic intervalvular fibrosa during the course of mitral valve endocarditis with aorto-left ventricle outflow tract fistula. J Saudi Heart Assoc 2012; 24:201-4. [PMID: 23960696 DOI: 10.1016/j.jsha.2012.02.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 01/30/2012] [Accepted: 02/04/2012] [Indexed: 10/28/2022] Open
Abstract
The mitro-aortic intervalvular fibrosa (MAIVF) connects the anterior mitral leaflet to the posterior portion of the aortic annulus. The pseudoaneurysm of MAIVF is one of the uncommon but catastrophic complications of native or prosthetic aortic valve endocarditis or chest trauma. We report a case of infective endocarditis of mitral valve complicated by development of pseudoaneurysm of MAIVF, and fistulous formation causing massive shunt flow from the ascending aorta above the non-coronary cusp to the left ventricle outflow tract.
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Affiliation(s)
- A Fazlinezhad
- Cardiovascular Research Center, Faculty of Medicine, Mashhad University of Medical Science (MUMS), Mashhad
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12
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Malclès G, Azarnoush K, Ravan R, Belhakem A, Tixier V, Bitar G, Ferrier N, Marcaggi X, Eberst E, Chabrot P, Miguel B, Camilleri L, Amat G, de Riberolles C. [Pseudo-aneurysm of mitro-aortic continuity: a rare complication after aortic valve replacement]. Ann Cardiol Angeiol (Paris) 2011; 60:296-299. [PMID: 21978821 DOI: 10.1016/j.ancard.2011.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2011] [Accepted: 08/04/2011] [Indexed: 05/31/2023]
Abstract
Pseudo-aneurysm of the fibrous continuity zone between the aortic and mitral valves, the so-called "mitral-aortic intervalvular fibrosa" is a rare complication of acute infective endocarditis, rarely after an aortic valve replacement. We report the case of a large pseudo-aneurysm occurred in a 70-year-old man, who had a history of surgical aortic valve replacement 3 years before. There were no biological or clinical evidence for infective acute endocarditis. The originality of this observation can be summarized in three points: the late onset after surgery, the absence of any infectious context and the chronic nature of pseudo-aneurysm, without any complication during a follow-up of 12 months. Transesophageal echocardiography remains the best diagnostic tool.
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Affiliation(s)
- G Malclès
- Service de cardiologie, centre hospitalier de Vichy, boulevard Denière, France
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Sudhakar S, Sewani A, Agrawal M, Uretsky BF. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF): A comprehensive review. J Am Soc Echocardiogr 2011; 23:1009-18; quiz 1112. [PMID: 20868952 DOI: 10.1016/j.echo.2010.07.015] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2010] [Indexed: 10/19/2022]
Abstract
Pseudoaneurysm in the region of the fibrous body between the mitral and aortic valve, the mitral-aortic intervalvular fibrosa (MAIVF), is a rare complication. The authors provide a comprehensive review of all relevant English-language articles published from 1966 to December 2009. Pseudoaneurysm of the MAIVF was identified in 88 patients in the medical literature and one from the authors' institution (total reported cases, 89). Endocarditis and aortic valve surgery were the most frequently associated causative factors. Symptoms and signs of infection, chest pain, heart failure or shortness of breath, and cerebrovascular accidents accounted for 77% of clinical presentations. The formation of a fistulous tract, coronary artery compression, and death were important described complications. Patients with ring abscesses in the MAIVF region and those with prosthetic aortic valves and histories of endocarditis are at higher risk for developing pseudoaneurysm of the MAIVF. Transesophageal echocardiography was able to identify all cases in which it was used. Surgical correction is the treatment of choice.
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Hasin T, Reisner SA, Agmon Y. Large pseudoaneurysms of the mitral-aortic intervalvular fibrosa: long-term natural history without surgery in two patients. Eur Heart J Cardiovasc Imaging 2011; 12:E24. [PMID: 21216766 DOI: 10.1093/ejechocard/jeq183] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
A pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a well-described complication of aortic valve endocarditis and aortic valve replacement. It may occasionally cause complications, but it may also remain uncomplicated and asymptomatic for unknown periods. Although corrective surgery is commonly recommended, the appropriate therapeutic approach to this pathology is unclear. The current report describes two patients with large pseudoaneurysms of the mitral-aortic intervalvular fibrosa, who were treated conservatively without surgery without any adverse clinical events during long-term follow-up. Therefore, conservative follow-up of this pathology with echocardiographic monitoring appears to be a valid and safe alternative for surgery, especially in patients at high risk for surgical intervention.
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Affiliation(s)
- Tal Hasin
- Echocardiography Laboratory and Heart Valves Clinic, Department of Cardiology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel
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15
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Kassim TA, Lowery RC, Nasur A, Corrielus S, Weissman G, Sears-Rogan P, Greenberg M, Singh S. Pseudoaneurysm of mitral–aortic intervalvular fibrosa: two case reports and review of literature. ACTA ACUST UNITED AC 2009; 11:E7. [DOI: 10.1093/ejechocard/jep189] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Spadaro GL, Zeppellini R, Rigo T, Iavernaro A, Zadro M, Chiominto B, Cucchini F. A rare case of mitro-aortic intervalvular fibrosa aneurysm evolving in the para-aortic cavity. J Cardiovasc Med (Hagerstown) 2009; 10:409-11. [DOI: 10.2459/jcm.0b013e328323d724] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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17
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Han J, He Y, Li Z, Chen J, Gu X, Pei J, Xie J, Kontos MC, Nixon JVI. Pseudoaneurysm of the mitral-aortic intervalvular fibrosa in a patient after radio frequency catheter ablation of atrial fibrillation. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2009; 28:249-251. [PMID: 19168775 DOI: 10.7863/jum.2009.28.2.249] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Affiliation(s)
- Jiancheng Han
- Department of Ultrasound, Beijing Anzhen Hospital, Capital Medical University, Beijing, China
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Salerno D, Donati G, Forconi S, Gori T. Giant pseudoaneurysm of the mitro-aortic intervalvular fibrosa: incidental diagnosis. Intern Emerg Med 2008; 3:279-82. [PMID: 18264672 DOI: 10.1007/s11739-008-0113-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2007] [Accepted: 07/12/2007] [Indexed: 11/26/2022]
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Ueno T, Sakata R, Iguro Y, Yamamoto H. Intervalvular fibrosa pseudoaneurysm with projectile shunt flow to left atrium. Interact Cardiovasc Thorac Surg 2008; 7:727-9. [DOI: 10.1510/icvts.2008.181230] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Kunavarapu C, Olkovsky Y, Lafferty JC, Homayuni AR, Mohan SS, McGinn J. Unusual Cardiac Complications of Staphylococcus aureus Endocarditis. J Am Soc Echocardiogr 2008; 21:187.e3-5. [PMID: 17683908 DOI: 10.1016/j.echo.2007.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2007] [Indexed: 11/20/2022]
Abstract
Bacterial endocarditis is a complex disease that is associated with significant morbidity and mortality. Staphylococcus aureus is an organism commonly responsible for acute bacterial infective endocarditis. Patients many times develop an acute fulminant infection resulting in multiple complications, even in the face of adequate therapy. We report an unusual case of S. aureus acute bacterial infective endocarditis in an immunocompromised patient resulting in multiple cardiac complications, including bacterial pericarditis with effusion, mycotic aneurysm of one of the coronary arteries, a valvular vegetation leading to an aneurysmal dilatation at the mitral-aortic junction (intervalvular fibrosa), and a fistulous communication between the left ventricle and left atrium. We present detailed echocardiographic images of these anomalies, which were subsequently confirmed intraoperatively. The patient underwent open heart surgery with pericardial patch repair of the mitral-aortic intervalvular fibrosa aneurysm and fistula.
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Affiliation(s)
- Chandra Kunavarapu
- Department of Cardiology, Medical College of Georgia, Augusta, Georgia 30912, USA.
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Jiménez Valero S, García E, González Pinto Á, Delcán JL. Cierre percutáneo de seudoaneurisma de la fibrosa mitroaórtica. Rev Esp Cardiol 2005. [DOI: 10.1016/s0300-8932(05)74079-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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