An unusual complication after aortic valve replacement

Abstract

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa, though rare, can occur after aortic valve replacement. We report an asymptomatic patient who developed this unusual complication and describe the use of transesophageal and 3-dimensional echocardiography to help confirm the diagnosis.

Correctness of multi-detector-row computed tomography for diagnosing mechanical prosthetic heart valve disorders using operative findings as a gold standard

“…The presenting symptoms included dyspnea, abdominal distension, leg edema, back pain, chest tightness, chronic cough and easy fatigue. Prosthetic valve disorders included pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) [3] and pseudoaneurysm formation [4].…”

“…These reports suggest that MDCT could be a good noninvasive imaging modality for prosthetic heart valve evaluation. However, there has been no prospective evaluation of the correctness or limitations of MDCT in various prosthetic valve disorders, including pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) [3] and pseudoaneurysm formation [4]. The goal of our study was to prospectively evaluate MDCT in diagnosing valve disorders, using operative findings as the gold standard.…”

“…With good compliance to anti-coagulant therapy, thrombosis is less likely to occur, but prosthetic valves might still have mechanical failure problems, such as pannus formation, prosthetic valve dysfunction, suture loosening (paravalvular leak) [3] and pseudoaneurysm formation [4]. Transthoracic or transesophageal echocardiography is usually limited by severe acoustic shadowing caused by the prosthetic valve itself, resulting in an incomplete evaluation [5,6].…”

Giant pseudoaneurysm of the mitro-aortic intervalvular fibrosa: incidental diagnosis

“…Gupta al. describe an asymptomatic MAIVF pseudoaneurysm that developed 5 years after aortic valve endocarditis necessitating valve replacement [5]. Finally, MAIVF pseudoaneurysm may result from blunt chest trauma [6,7], stab wounds [8] or can be congenital [9].…”

Idiopathic left ventricular outflow tract pseudoaneurysm

“…The LVOT pseudoaneurysm has been reported in patients having history of cardiac surgery, myocardial infarction, prosthetic aortic valve replacement, infective endocarditis, chest trauma and congenital heart diseases particularly outlet type of ventricular septal defect. [1][2][3][4][5][6][7] Mitral -aortic intervalvular fibrosa is predominantly fibrous, avascular, and is prone to infection and trauma which can lead to aneurysm formation. [8] The symptomatology is usually vague and is secondary to obstruction produced by the aneurysmal sac of the surrounding structures like LVOT, coronary arteries, pulmonary artery, left atrium, and left main bronchus or it may be fatal if it ruptures in these structures.…”