Large pseudoaneurysms of the mitral-aortic intervalvular fibrosa: long-term natural history without surgery in two patients

• Published in: European journal of echocardiography Vol. 12; no. 3; p. E24
• Main Authors: Hasin, Tal, Reisner, Shimon A, Agmon, Yoram
• Format: Journal Article
• Language: English
• Published: England 01-03-2011
• Subjects: Adult; Aneurysm, False - diagnostic imaging; Aneurysm, False - etiology; Aneurysm, False - therapy; Aortic Valve - diagnostic imaging; Aortic Valve - pathology; Aortic Valve Insufficiency - diagnostic imaging; Aortic Valve Insufficiency - surgery; Bioprosthesis - adverse effects; Echocardiography, Transesophageal; Endocarditis, Bacterial - complications; Endocarditis, Bacterial - diagnosis; Follow-Up Studies; Heart Aneurysm - diagnostic imaging; Heart Aneurysm - etiology; Heart Aneurysm - therapy; Heart Valve Prosthesis Implantation - adverse effects; Heart Valve Prosthesis Implantation - methods; Humans; Male; Middle Aged; Mitral Valve - diagnostic imaging; Mitral Valve - pathology; Monitoring, Physiologic - methods; Risk Assessment; Severity of Illness Index; Time Factors
• ISSN: 1532-2114
• DOI: 10.1093/ejechocard/jeq183

A pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a well-described complication of aortic valve endocarditis and aortic valve replacement. It may occasionally cause complications, but it may also remain uncomplicated and asymptomatic for unknown periods. Although corrective surgery is commonly recommended, the appropriate therapeutic approach to this pathology is unclear. The current report describes two patients with large pseudoaneurysms of the mitral-aortic intervalvular fibrosa, who were treated conservatively without surgery without any adverse clinical events during long-term follow-up. Therefore, conservative follow-up of this pathology with echocardiographic monitoring appears to be a valid and safe alternative for surgery, especially in patients at high risk for surgical intervention.