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Boumaaz M, Lahjouji MR, Faraj R, Mouine N, Asfalou I, Benyass A. Rare complications of infective endocarditis in marfan-like morphotype: diagnosis of multiple mitral valve aneurysms and aortic root abscess using three-dimensional transesophageal echocardiography. BMC Cardiovasc Disord 2024; 24:51. [PMID: 38221637 PMCID: PMC10788978 DOI: 10.1186/s12872-024-03715-3] [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: 11/26/2023] [Accepted: 01/05/2024] [Indexed: 01/16/2024] Open
Abstract
Mitral valve aneurysm (MVA) is characterized by a saccular outpouching of the mitral leaflet, and it represents a rare condition typically associated with aortic valve endocarditis. Three-Dimensional Transesophageal Echocardiography (3D-TEE) serves as an effective tool for detecting the presence of MVA and its potential complications. In this report, we present a case involving a young man with striking images of bicuspid aortic valve endocarditis complicated by an aortic root abscess and multiple perforated mitral valve aneurysms, diagnosed using 3D TEE. This case suggests the uncommon coexistence of Marfan like morphotype, bicuspid aortic valve, and infective endocarditis as a triple mechanism in the occurrence of MVA. It underscores the significance of early and accurate imaging diagnosis for facilitating prompt surgical intervention.
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Affiliation(s)
- Meriem Boumaaz
- Department of Cardiology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Mohamed Reda Lahjouji
- Department of Cardiology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Raid Faraj
- Department of Cardiology B, Ibn Sina University Hospital, Mohammed V University, Rabat, Morocco.
| | - Najat Mouine
- Department of Cardiology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Iliyasse Asfalou
- Department of Cardiology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Aatif Benyass
- Department of Cardiology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
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Wang Y, Wang S, Chen D, Li M, Mi S, Xiong L, Song W, Wang W, Yin S, Wang B. Mitral valve aneurysms: echocardiographic characteristics, formation mechanisms, and patient outcomes. Front Cardiovasc Med 2023; 10:1233926. [PMID: 37692047 PMCID: PMC10491013 DOI: 10.3389/fcvm.2023.1233926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Accepted: 08/02/2023] [Indexed: 09/12/2023] Open
Abstract
Background The accurate etiology of mitral valve aneurysm (MVA) formation is not completely understood, and the most effective management approach for this condition remains controversial. Methods We retrospectively analyzed 20 MVA patients who underwent either surgical interventions or conservative follow-ups at the Zhongnan Hospital of Wuhan University between 2017 and 2021. We examined their clinical, echocardiographic, and surgical records and tracked their long-term outcomes. Results Of the 20 patients, 12 were diagnosed with MVA using transthoracic echocardiography, seven required additional transesophageal echocardiography for a more definitive diagnosis, and one child was diagnosed during surgery. In all these patients, the MVAs were detected in the anterior mitral leaflet. We found that 15 patients (75%) were associated with infective endocarditis (IE), whereas the remaining patients were associated with bicuspid aortic valve and moderate aortic regurgitation (AR) and mild aortic stenosis (5%), congenital heart disease (5%), elderly calcified valvular disease (5%), mitral valve prolapse (5%), and unknown reasons (5%). Of the 17 patients who underwent hospital surgical interventions, two died due to severe cardiac events. The remaining 15 patients had successful surgeries and were followed up for an average of 13.0 ± 1.8 months. We observed an improvement in their New York Heart Association functional class and mitral regurgitation and AR degrees (P-value < 0.001). During follow-up, only one infant had an increased left ventricular end-diastolic diameter and left ventricular end-systolic diameter, whereas the remaining 14 patients had decreased values (P < 0.001). In addition, none of the three conservatively managed patients experienced disease progression during the 7-24 months of follow-up. Conclusions We recommend using echocardiography as a highly sensitive method for MVA diagnosis. Although most cases are associated with IE or AR, certain cases still require further study to determine their causes. A prompt diagnosis of MVA in patients using echocardiography can aid in its timely management.
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Affiliation(s)
- Yi Wang
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Shuang Wang
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Dandan Chen
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Mengmei Li
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Sulin Mi
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Li Xiong
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Wanwan Song
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Wei Wang
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
| | - Shanye Yin
- Department of Pathology, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Bin Wang
- Department of CardiovascularUltrasound, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, China
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Oliveira I, Cruz I, Neto A, Bragança B, Abreu G, Azevedo J, Andrade A. Mitral Valve Perforated Aneurysm: An Issue of Inflammation or Pressure Gradients? Arq Bras Cardiol 2022; 119:S0066-782X2022005017203. [PMID: 36228278 PMCID: PMC9750205 DOI: 10.36660/abc.20211031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 03/09/2022] [Accepted: 05/11/2022] [Indexed: 11/18/2022] Open
Affiliation(s)
- Inês Oliveira
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - Isabel Cruz
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - Ana Neto
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - Bruno Bragança
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - Glória Abreu
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - João Azevedo
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
| | - Aurora Andrade
- Departamento de CardiologiaCentro Hospitalar Tâmega e SousaPenafielPortugal Departamento de Cardiologia , Centro Hospitalar Tâmega e Sousa, Penafiel – Portugal
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Reyaldeen R, Lo Presti Vega S, Elgharably H, Xu B. More Than a Simple Vegetation: The Trifecta of Mitral Valve Leaflet Perforation, Windsock Aneurysm, and Mitral Valve Abscess. ACTA ACUST UNITED AC 2020; 5:20-25. [PMID: 33644509 PMCID: PMC7887516 DOI: 10.1016/j.case.2020.10.008] [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] [Indexed: 11/29/2022]
Abstract
MV abscesses and aneurysms are uncommon complications of IE. Serial echocardiography is important to identify perivalvular complications. Three-dimensional transesophageal echocardiography has incremental value in diagnosis.
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Affiliation(s)
- Reza Reyaldeen
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Saberio Lo Presti Vega
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Haytham Elgharably
- Department of Thoracic and Cardiovascular Surgery, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
| | - Bo Xu
- Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Sydell and Arnold Miller Family Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
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Werner ME, Riezebos RK, Kuipers RS. A Perforated Mitral Valve Aneurysm: A Rare but Serious Complication of Aortic Valve Endocarditis Resulting From a Regurgitant Jet Lesion. Cureus 2020; 12:e11644. [PMID: 33376655 PMCID: PMC7755663 DOI: 10.7759/cureus.11644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Infective endocarditis has high morbidity and mortality rates. The aortic valve is most often affected in native valve endocarditis. Complications of aortic valve endocarditis range from local abscess and fistula formation, systemic complications secondary to thromboembolism and septic embolization, to congestive heart failure resulting from conduction system involvement and valve damage. A rare complication of aortic valve endocarditis is the occurrence of a ‘jet lesion’ on the mitral valve. Such a lesion, caused by an impinging regurgitant jet stream from a damaged aortic valve, can become directly and indirectly inoculated and evolve into a local infected aneurysm which might eventually rupture causing acute severe congestive heart failure and/or peripheral thromboembolism. We present the case of a 63-year-old man who presented with aortic valve endocarditis complicated by a perforated mitral valve aneurysm, congestive heart failure, and peripheral thromboembolism.
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Nguyen D, Vo A, Pham C, Nguyen T, Vu T, Le K, Nguyen B. Minimally invasive surgical repair of accessory mitral valve tissue: A case report. Int J Surg Case Rep 2020; 72:160-162. [PMID: 32535533 PMCID: PMC7299900 DOI: 10.1016/j.ijscr.2020.05.080] [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: 04/06/2020] [Revised: 05/22/2020] [Accepted: 05/25/2020] [Indexed: 11/01/2022] Open
Abstract
INTRODUCTION Accessory mitral valve tissue is a rare congenital disease of the mitral valve. It is usually associated with other cardiac malformations and/or left ventricular outflow tract obstruction. More than 2/3 of patients were diagnosed in their childhood. Treatment can be conservative or surgical. The suitable timing for surgery remains controversial, some authors suggest early intervention to prevent devastating complications. CASE REPORT We report a case of an adult patient with accessory mitral valve tissue causing left ventricular outflow tract obstruction, who was treated surgically via the right minithoracotomy.
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Affiliation(s)
- Dinh Nguyen
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Anh Vo
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam.
| | - Chuong Pham
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Trang Nguyen
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Thanh Vu
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Khoi Le
- Department of Cardiovascular Surgery, University Medical Center, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
| | - Bac Nguyen
- Department of Surgery, University of Medicine and Pharmacy at Ho Chi Minh City, Ho Chi Minh City, Viet Nam
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