Mitral-aortic intervalvular fibrosa pseudoaneurysm resulting in the displacement of the left main coronary artery after aortic valve replacement

Kim, Hwan Wook; Chung, Cheol Hyun

doi:10.1016/j.jtcvs.2008.07.045

Cited by 16 publications

(12 citation statements)

References 5 publications

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“…In these reports, repair was performed with redo-AVR and patch closure of P-MAIVF. [9,10] The present patient also had undergone repair of P-MAIVF which failed and recurred. Recurrence with MR and AR favored Double Valve Replacement (DVR) wherein the MAIVF region was interposed between the two prosthetic valve-sewing rings.…”

Section: Discussionmentioning

confidence: 74%

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

et al. 2014

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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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Section: Discussionmentioning

confidence: 74%

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

et al. 2014

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“…It is thought that the process leading to an ACF is the resulting inflammation from the bacterial colonization of the valve and surrounding tissue with subsequent abscess formation, creating erosion of the sinus of Valsalva ( 1 – 3 ). The intervalvular fibrosa is particularly prone to infection given its avascularity and infected regurgitation of jet striking subvalvular structures ( 4 ).…”

Section: Discussionmentioning

confidence: 99%

Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

Galeas¹,

Perez²,

Villablanca³

et al. 2015

Journal of Community Hospital Internal Medicine Perspectives

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“…Diagnosis is made by visualization of systolic expansion and diastolic collapse of the P-MAIF, along with systolic turbulent flow seen on echocardiogram [5]. Diagnosis is more accurate with a transesophageal echocardiogram than with a transthoracic echocardiogram and the sensitivity may increase up to 90% from 43%, respectively [5].…”

Section: Discussionmentioning

confidence: 99%

“…Diagnosis is more accurate with a transesophageal echocardiogram than with a transthoracic echocardiogram and the sensitivity may increase up to 90% from 43%, respectively [5]. Other testing modalities include coronary angiography to evaluate for coronary compression or atherosclerotic coronary disease and computed tomography or magnetic resonance imaging to evaluate the extent of a pseudoaneurysm and its effect on adjacent structures within the chest [3].…”

Section: Discussionmentioning

confidence: 99%

SubacuteStaphylococcus epidermidisBacterial Endocarditis Complicated by Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm

Elegino-Steffens

Stratton

Geimer-Flanders

2012

Case Reports in Cardiology

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The patient is a 75-year-old man with a history significant for hypertension and congestive heart failure who underwent a bioprosthetic aortic valve replacement secondary to acute onset of aortic insufficiency. Cultures of the native valve were positive for Staphylococcus epidermidis sensitive to nafcillin and intravenous cefazolin was initiated. On postoperative day 24, he developed acute decompensated heart failure. A transesophageal echocardiogram demonstrated a structurally abnormal mitral valve with severe regurgitation, anterior and posterior leaflet vegetations, and scallop prolapse. There was also evidence of a mitral-aortic intervalvular fibrosa pseudoaneurysm (P-MAIF) with systolic expansion and flow within the aneurysm. Antibiotic treatment was changed from cefazolin to vancomycin for presumed development of methicillin-resistant Staphylococcus. He subsequently underwent a bioprosthetic mitral valve replacement and has restoration of health without sequella. This case highlights the development of a P-MAIF as a rare complication of both aortic or mitral valve replacement and infective endocarditis.

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Mitral-aortic intervalvular fibrosa pseudoaneurysm resulting in the displacement of the left main coronary artery after aortic valve replacement

Cited by 16 publications

References 5 publications

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

Repair of recurrent pseudoaneurysm of the mitral-aortic intervalvular fibrosa: Role of transesophageal echocardiography

Aortocavitary fistula as a complication of infective endocarditis and subsequent complete heart block in a patient with severe anemia

SubacuteStaphylococcus epidermidisBacterial Endocarditis Complicated by Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm

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