Turk Kardiyol Dern Ars. 2009; 37(4): 263-265

Mitral valve aneurysm associated with aortic valve regurgitation

Öykü Gülmez¹, Leyla Elif Sade², Aylin Yıldırır², Haldun Müderrisoğlu^2
1Department of Cardiology, Başkent University İstanbul Medical and Research Center, İstanbul
²Department of Cardiology, Medicine Faculty of Başkent University, Ankara

Mitral valve aneurysm (MVA) is uncommon and occurs most commonly in association with infective endocarditis involving the aortic valve. A 66-year-old man with anterior MVA is presented. Two-dimensional transthoracic echocardiography and transesophageal echocardiography revealed a saccular structure in the anterior mitral leaflet that bulged into the left atrium throughout the cardiac cycle, a localized aneurysmal lesion of the aortic valve, and severe mitral and aortic regurgitation. There were neither vegetations nor atrial thrombi and his medical record was not suggestive of any episode of infective endocarditis. The mitral and aortic valves were replaced with mechanical protheses. Pathologic examination of the excised valves showed inflammation and cultures were negative. The postoperative course was uneventful, and the patient was discharged on the fifth postoperative day. In this case, MVA is likely to result from previous infective endocarditis of the aortic valve leading to aneurysm formation and severe aortic regurgitation.

Keywords: Aortic valve insufficiency, echocardiography, endocarditis, bacterial/complications; heart aneurysm/pathology/surgery; mitral valve/pathology.

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