Korean Circ J.  2001 Jul;31(7):701-706. 10.4070/kcj.2001.31.7.701.

Mitral-aortic Intervalvular Fibrosa Pseudoaneurysm with Dual Fistula that Occurred in Prosthetic Aortic Valve Endocarditis

• Won TK
• Kim IW
• Kim JK
• Lim DS
• Kim WS
• Hong SG
• Hwang HK

• KMID: 2029555
• DOI: http://doi.org/10.4070/kcj.2001.31.7.701

Abstract

The Iinvolvement of subaortic structures in the aortic valve endocarditis appears more commonly than previously recognized. These subaortic complications are most commonly located in the mitral-aortic intervalvular fibrosa and may be presented as abscess, or as pseudoaneurysm with or without perforation. Perforated pseudoaneurysm can lead to the development of communication between the left ventricular outflow tract and various cardiac chambers, most commonly the left atrium. These complications are related with poor prognosis. Early and precise recognition of these complications is important for optimal treatment. At present, transesophageal echocardiography (TEE) has been validated as the technique of choice. We describe a case of infectious pseudoaneurysm of mitral-aortic intervalvular fibrosa featuring the connection of the fistulous simultaneously to the left atrium and aorta. In our case, accurate interpretation of TEE imaging revealing the subaortic structures was not so easy due to interference of both aortic and mitral prosthetic valves. We expect the further development of (Ed-confirming that here you don't intend, "We expect to further develop") TEE and other imaging modalities to substantially improve the future diagnosis of these undesirable complications.

Keyword

Aortic valve endocarditis; Mitral-aortic intervalvular fibrosa; Perforated pseudoaneurysm; TEE

MeSH Terms

Abscess
Aneurysm, False*
Aorta
Aortic Valve*
Diagnosis
Echocardiography, Transesophageal
Endocarditis*
Fistula*
Heart Atria
Prognosis