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[Pseudoaneurysm of the left ventricle after mitral valve replacement. Diagnosis 6 years after the intervention]
E Antonielli1, F Di Bono, A Pizzuti
1Divisione di Cardiologia, Ospedale SS. Annunziata, Savigliano, Cuneo.
Insights
A rare left ventricular pseudoaneurysm was incidentally found 6 years after mitral valve surgery. Imaging techniques confirmed the stable, asymptomatic condition, leading to a conservative management approach.
Area of Science:
- Cardiology
- Cardiac Surgery
- Diagnostic Imaging
Background:
- Left ventricular pseudoaneurysms are rare but serious complications following cardiac surgery.
- Mitral valve replacement, particularly with prosthetic devices like the St. Jude prosthesis, carries potential risks.
Observation:
- A case is presented of a left ventricular pseudoaneurysm discovered incidentally 6 years post-mitral valve replacement.
- The pseudoaneurysm was identified through a combination of cross-sectional and color-Doppler echocardiography.
- Transesophageal echocardiography provided limited additional information, while computed tomography with contrast confirmed the diagnosis.
Findings:
- Retrospective analysis indicated the pseudoaneurysm formed shortly after the initial mitral valve surgery.
- The pseudoaneurysm remained clinically asymptomatic and stable in size over a 6-year period and a 2-year follow-up.
- The patient remained asymptomatic throughout the observation period.
Implications:
- This case highlights the importance of considering rare complications even years after cardiac procedures.
- Advanced imaging modalities are crucial for accurate diagnosis and characterization of cardiac abnormalities.
- Conservative management may be a viable option for stable, asymptomatic left ventricular pseudoaneurysms.
Abstract:
We present a case of left ventricular pseudoaneurysm diagnosed by chance 6 years after a second surgical intervention on the mitral valve (replacement with a St. Jude prosthesis). A combination of cross sectional and color-Doppler studies led to the correct diagnosis. A transesophageal echocardiographic investigation did not provide further information, while the diagnosis was confirmed by computed tomography with contrast agent. A retrospective analysis of previous examinations revealed that the pseudoaneurysm developed shortly after the mitral valve replacement, remaining stable over the years. The patient was clinically asymptomatic, the size of the pseudoaneurysm did not increase during a 2 years followup, and we decided to follow a conservative treatment.