Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography.
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Date
2014-04
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Abstract
Pseudoaneurysm of mitral‑aortic intervalvular fibrosa (P‑MAIVF) is a rare cardiac surgical condition. P‑MAIVF
commonly occurs as a complication of aortic and mitral valve replacement surgeries. The surgical trauma
during replacement of the valves weakens the avascular mitral and aortic intervalvular area. We present a
case of P‑MAIVF recurrence 5 years after a primary repair. Congestive cardiac failure was the presenting
feature with mitral and aortic regurgitation. In view of the recurrence, the surgical team planned for a double
valve replacement. The sewing rings of the two prosthetic‑valves were interposed to close the mouth of the
pseudoaneurysm and to provide mechanical reinforcement of the MAIVF. Intra‑operative transesophageal
echocardiography (TEE) helped in delineating the anatomy, extent of the lesion, rupture of one of the
pseudoaneurysm into left atrium and severity of the valvular regurgitation. Post‑procedure TEE confirmed
complete obliteration of the pseudoaneurysm and prosthetic valve function.
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Keywords
Double‑valve replacement, Mitral‑aortic intervalvular fibrosa, Pseudoaneurysm, Transesophageal echocardiography
Citation
Joshi Shreedhar S, Thimmarayappa Ashwini, Nagaraja P S, Jagadeesh A M, Furtado Arul, Bhat Seetharam. Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography. Annals of Cardiac Anaesthesia. 2014 Apr; 17(2): 152-154.