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Ruptured pseudo-aneurysm of the mitral-aortic intervalvular fibrosa - A 3D transesophageal echocardiographic

Parveen Kumar1, Kumar Kenchappa2, Suryakant Jena2

  • 1Department of Cardiology, Eternal Hospital, Jaipur, Rajasthan, India.

Journal of Cardiology Cases
|October 4, 2018
PubMed

Insights

Pseudo-aneurysm of the mitral-aortic intervalvular fibrosa (MAIVF) is a rare complication. Three-dimensional transesophageal echocardiography is crucial for diagnosing MAIVF ruptures and guiding treatment strategies.

Area of Science:

  • Cardiology
  • Medical Imaging

Background:

  • Pseudo-aneurysm of the mitral-aortic intervalvular fibrosa (MAIVF) is a rare but serious complication, often associated with native or prosthetic valve endocarditis.
  • Accurate imaging is paramount for the diagnosis and effective management of MAIVF.

Observation:

  • This case report details a pseudo-aneurysm of the MAIVF that ruptured into the left atrium in a patient who had undergone double valve replacement.
  • The observation specifically highlights the utility of three-dimensional transesophageal echocardiography (3D-TEE) in visualizing this rare entity.

Findings:

  • 3D-TEE provided clear anatomical detail of the pseudo-aneurysm, distinguishing it from an abscess.
  • The imaging revealed a pulsatile, pouch-like structure extending into the left atrium, crucial for understanding the rupture dynamics.

Implications:

  • Real-time 3D-TEE offers valuable insights into the complex anatomy of MAIVF pseudo-aneurysms.
  • This advanced imaging modality aids in differentiating pseudo-aneurysms from abscesses, which is critical for treatment planning.
  • The detailed visualization assists in formulating optimal surgical or device-based therapeutic strategies for affected patients.
Keywords:
Aortomitral intervalvular fibrosaProsthetic valvePseudoaneurysmTransesophageal echocardiography

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