Mitral valve aneurysms: Clinical characteristics, echocardiographic abnormalities, and possible mechanisms of formation

Mitral valve aneurysms: Clinical characteristics, echocardiographic abnormalities, and possible mechanisms of formation

Aims Mitral valve aneurysms (MVA) are most frequently associated with endocarditis. Echocardiography is the method of choice for diagnosis, and color flow imaging is an important, easy method to detect MVA ruptures. We aimed to study the clinical and echocardiographic findings and their relation to...

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Published in:Echocardiography (Mount Kisco, N.Y.) Vol. 34; no. 7; pp. 986 - 991
Main Authors: Pena, José Luiz B., Bomfim, Tarciso O., Fortes, Paulo R. L., Simão‐Filho, Charles, Souza Andrade‐Filho, José
Format: Journal Article
Language:English
Published: United States 01-07-2017
Subjects:
Adolescent
Adult
Aged
cardiac surgery
Child
echocardiography
Echocardiography - methods
Echocardiography, Transesophageal - methods
Female
Heart Aneurysm - diagnostic imaging
Heart Aneurysm - physiopathology
Humans
infective endocarditis
Male
Middle Aged
Mitral Valve - diagnostic imaging
Mitral Valve - physiopathology
mitral valve aneurysm
Young Adult
cardiac surgery
mitral valve aneurysm
infective endocarditis
echocardiography
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Summary:Aims Mitral valve aneurysms (MVA) are most frequently associated with endocarditis. Echocardiography is the method of choice for diagnosis, and color flow imaging is an important, easy method to detect MVA ruptures. We aimed to study the clinical and echocardiographic findings and their relation to the mechanism of aneurysm formation. Methods and Results We reviewed clinical and echocardiographic records of 18 patients during a 17‐year period, corresponding to 0.02% of the total studies performed at our institution. All patients underwent transthoracic echocardiogram (TTE), and all except two underwent transesophageal echocardiogram (TEE). The aneurysm was located either on the anterior leaflet (16 cases) or on the posterior leaflet (two cases). In seven cases, the probable aneurysm formation mechanism was an aortic regurgitant jet striking the anterior mitral leaflet. Perforation was present in 17 (94.4%) patients, and 10 (55.5%) cases presented more than one aneurysm. No patients underwent surgery exclusively because of the echocardiography finding. Conclusion Different etiologies and formation mechanisms can occur in MVA. Echocardiography plays a fundamental role, providing meticulous examination of the mitral valve anatomy and flow. Unlike standard recommendations, clinical management is possible, and diagnosis does not imply immediate surgical correction.
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ISSN:0742-2822
1540-8175
DOI:10.1111/echo.13556