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Updated: Mar 11, 2026

A Simplified Stepwise Approach to Echo Guidance during Percutaneous Mitral Valve Repair
Published on: October 16, 2021
Severe mitral regurgitation due to mitral leaflet aneurysm diagnosed by three-dimensional transesophageal
Takao Konishi1,2, Naohiro Funayama3, Tadashi Yamamoto3
1Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan. takaokonishi0915@gmail.com.
Background:
A small mitral valve aneurysm (MVA) presenting as severe mitral regurgitation (MR) is uncommon.
Case Presentation:
A 47-year-old man with a history of hypertension complained of exertional chest discomfort. A transthoracic echocardiogram (TTE) revealed the presence of MR and prolapse of the posterior leaflet. A 6-mm in diameter MVA, not clearly visualized by TTE, was detected on the posterior leaflet on a three-dimensional (3D) transesophageal echocardiography (TEE). The patient underwent uncomplicated triangular resection of P2 and mitral valve annuloplasty, and was discharged from postoperative rehabilitation, 2 weeks after the operation. Histopathology of the excised leaflet showed myxomatous changes without infective vegetation or signs of rheumatic heart disease.
Conclusions:
A small, isolated MVA is a cause of severe MR, which might be overlooked and, therefore, managed belatedly. 3D TEE was helpful in imaging its morphologic details.
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