Mitral and aortic valve aneurysms secondary to infective endocarditis: impressive images of a rare echocardiographic finding

Abstract

Mitral and aortic valve aneurysms are uncommon, but the coexistence of both mitral and aortic valve aneurysms in the same patient is a rather unusual finding in the literature. We report a rare clinical case of a patient with both mitral and aortic valve aneurysms and a rupture of the mitral valve aneurysm, as the main echocardiographic manifestations of infective endocarditis. This clinical case emphasizes infective endocarditis as the most frequent cause of valve aneurysms, reminding that this diagnosis should be suspected even in the absence of vegetations. This case demonstrates that transoesophageal echocardiography plays a major role on diagnosis of valve aneurysms, revealing the rupture of the mitral valve aneurysm and defining this rupture as the main mechanism of mitral valve regurgitation. This case also underlines the role of transoesophageal echocardiography on management decisions, allowing a morphological evaluation of the mitral valve and selection of the appropriate surgical strategy.

Aortic valve aneurysm associated with infective endocarditis: case report and review of literature

“…We found 17 surgical cases of aortic valve aneurysms [2,[4][5][6][7][8][9][10][11][12][13][14][15][16], these are summarized in Table 1, with the addition of our case.…”

Severe mitral regurgitation due to mitral leaflet aneurysm diagnosed by three-dimensional transesophageal echocardiography: a case report

“…Its formation is associated with congenital, structural diseases of the connective tissues, including Marfan’s syndrome [8], mitral valve prolapse [15], LV outflow tract obstruction, hypertrophic cardiomyopathy [16, 17] and bicuspid or quadricuspid aortic valves [18, 19]. From these predisposing disorders, MVA is formed by acquired factors, such as rheumatic fever, Libman-Sachs endocarditis and, in most cases, infective endocarditis [2, 3, 20–22]. It is usually detected on the anterior leaflet, due to infective endocarditis caused by an aortic regurgitant jet striking the leaflet [9, 21, 22].…”

“…Mitral valve aneurysm (MVA), a rare disorder first described by Saphir and Leroy in 1948 [1], is usually a complication of infective endocarditis [2–7]. Other causes of this disorder are rheumatic heart disease, Marfan’s syndrome [8], aortic regurgitation and hypertrophic cardiomyopathy.…”

Infective Endocarditis Complicated by Mitral Valve Aneurysm: Pathologic and Echocardiographic Correlations

“…In the literature, most cases describe mitral valve involvement; however, aortic and tricuspid valve aneurysms due to endocarditis have also been described . The most common cause is infective endocarditis . In particular, mitral valve aneurysms occur in association with aortic valve endocarditis.…”