A large special posterior mitral valve aneurysm without infective endocarditis and literature review

Abstract

Background Mitral valve aneurysm (MVA) was a saccular bulging on mitral valves. It often occurred in anterior leaflet and commonly caused by aortic valve regurgitation complicated by infective endocarditis. Case presentation We reported a 68-year-old female with MVA of posterior leaflet without infective endocarditis. The aneurysm was large and the characteristics of its echo imaging was special, because the saccular structure did not collapse during diastole in real time three dimentional transesophageal echocardiography (RT-3D-TEE). But direct communication between the mass and the left ventricle was detected in this patient. This jet flow from left ventricle into the aneurysm help us distinguish MVA from mass. The patient was uneventful after mitral valve plasty surgery in 2 years’ follow-up. Conclusion We diagnosed a large MVA of posterior leaflet without endocarditis by RT-3D-TEE here. Large MVAs did not collapse in diastole, but the jet flow from left ventricle into the aneurysm can help us distinguish MVA from mass. Besides, RT-3D-TEE was more reliable to diagnose and assess MVA than 2-dimentional transthoracic echocardiography.