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Mycotic mitral valve aneurysm (MVA) is a rare complication that may develop in the course of isolated mitral valve (MV) infective endocarditis (IE). The anterior MV leaflet is most commonly affected; however, aneurysms of the posterior mitral leaflet have been rarely reported. 1 Potential complications of MVA include thrombus formation, rupture, or perforation with subsequent severe mitral regurgitation (MR) or embolic events. In these cases, surgery is indicated and usually urgent. 2 Currently, three-dimensional (3D) transesophageal echocardiography (TEE) plays a crucial role for characterization and appropriate surgical approach of MVA. 3 We present here a case of a ruptured posterior mycotic MVA with massive MR and an unusual cicatrization process that led to the virtual disappearance of the MR.

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