Submitral left ventricular pseudoaneurysm after mitral valve replacement: early diagnosis and successful repair

Abstract

Late left ventricle (LV) rupture with pseudoaneurysm after mitral valve replacement is rare. We report its early diagnosis by advanced technologies, e.g. MRI and successful repair of a type I AV rupture through left atrial approach.

Linksventrikuläres Pseudoaneurysma nach Mitralklappenersatz

“…The most common clinical presentation in the reviewed articles was shortness of breath/heart failure. Dyspnea and heart failure were the major symptoms for 35 patients [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20]. Six patients had been asymptomatic at the time of diagnosis [21][22][23][24][25][26], whereas six other patients had described chest pain [3,11,12,19,27,28].…”

“…Transthoracic echocardiography (TTE) was performed on 49 patients. Definitive diagnoses were made for 43 patients using TTE, as well as transesophageal echocardiography [2,6,8,10,[16][17][18]23], computed tomography [2-8, 11, 14, 16, 19, 21-23, 25-29], and heart catheterization [6,7,11,15,20,21,23,24,27] as additional visualization methods. Suspected pericardial pathology was observed in four patients with TTE; the diagnosis was confirmed by transesophageal echocardiography [8] and computed tomography [7,11,27] in these patients.…”

Severe Mitral Regurgitation After Left Ventricular Pseudoaneurysm Repair

“…[1][2][3][4][5][6][7][8] Other conditions can also lead to pseudoaneurysm formation and include LV trauma, prior LV surgery, LV foreign body infection, myocarditis, and LV posterior wall rupture complicating mitral valve replacement. [1][2][3][4][5][6][7][8] Left ventricular pseudoaneurysms have been associated with the development of significant mitral regurgitation (MR) requiring mitral valve replacement.…”

“…[1][2][3][4][5][6][7][8] Other conditions can also lead to pseudoaneurysm formation and include LV trauma, prior LV surgery, LV foreign body infection, myocarditis, and LV posterior wall rupture complicating mitral valve replacement. [1][2][3][4][5][6][7][8] Left ventricular pseudoaneurysms have been associated with the development of significant mitral regurgitation (MR) requiring mitral valve replacement. 9 Since most pseudoaneurysms occur in the basal aspect of the LV, they can distort the geometry of the mitral valve (MV) apparatus and cause MR. Repair of a basal pseudoaneurysm with a patch can decrease MR by improving the geometry of the LV and MV apparatus.…”

Letter to the editor Systolic compression of left main coronary artery by left ventricular pseudoaneurysm complicated by critical stenosis of left main coronary artery

“…The majority of patients have electrocardiographic abnormalities which are usually nonspecific ST-segment changes. Lethal complications of LV pseudoaneurysm are LV failure, LV thrombus formation, embolization, rupture of the aneurysm and death [5]. …”