Pseudoaneurysm of the mitral–aortic intervalvular fibrosa presenting after chest trauma and diagnosed by cardiac magnetic resonance: a case report

Abstract

IntroductionAnnular subvalvular pseudoaneurysm is a rare example of left ventricle aneurysm described predominantly in young African people. These aneurysms are divided into two different types, namely, submitral or subaortic, with subaortic being the less frequent kind. The subaortic type is most often localized in the mitral–aortic intervalvular fibrosa. To the best of our knowledge, this is the first report of a mitral–aortic intervalvular fibrosa pseudoaneurysm associated with coarctation of the aorta, anomalous pulmonary venous return, bicuspid aortic valve and patent ductus arteriosus diagnosed by cardiovascular magnetic resonance.Case presentationWe report the case of a 15-year-old African-American boy with a history of mild chest trauma who underwent echocardiographic evaluation as part of an out-patient work up. The echocardiogram was suspicious for the presence of mitral-aortic intervalvular fibrosa pseudoaneurysm and cardiovascular magnetic resonance was then performed to better characterize this finding. In addition to confirming the presence of the aneurysm, cardiovascular magnetic resonance also revealed coarctation of the aorta, a bicuspid aortic valve, and anomalous pulmonary venous return.ConclusionIn our case, cardiovascular magnetic resonance was helpful in: (a) making a definite diagnosis of mitral–aortic intervalvular fibrosa pseudoaneurysm and its borders, which was not clear with an echocardiogram examination; and (b) illustrating additional associated congenital anomalies including the anomalous pulmonary venous return.

Congenital pseudoaneurysm of mitral-aortic intervalvular fibrosa masquerading as left atrial mass in fetal life

“…in 2012 have illustrated a type of subvalvular ventricular aneurysm occurring at the MAIVF site. [67] Location of the defect seen in our case seems similar to the above mentioned, but of congenital origin. So far, only two cases of congenital pseudoaneurysm at this site have been reported to the best of our knowledge.…”

Septic Shock of Unknown Origin: A Case Report of a Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa

“…Aortic valve surgery is the most frequent condition, but other procedures have been associated with P-MAIVF, including ventricular septal defect repair, Ross/Konno procedure, cardiac catheterization, radio-frequency catheter ablation of atrial fibrillation, and mitral valve surgery with maze procedure [ 1 ]. Chest trauma has been described as the basis for the P-MAIVF formation [ 1-4 , 12 ].…”

Echocardiographic Diagnosis and Outcome of Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa

“…9 , 10 Endocarditis and aortic valve surgery were considered the 2 most frequently associated causative factors for P-MAIVF. 1 P-MAIVF can also occur in patients without a prosthetic aortic valve, 11 being associated with chest trauma, 12 with Takayasu's arteritis 13 or congenital abnormality. 14 All patients in this study had their natural valves, which differs from previous reports.…”