Left ventricular pseudoaneurysm as a complication of prosthetic mitral valve infective endocarditis

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• 作者：Junichi Shimotakahara ; MD^a ; ^{shimotakaj@gmail.com} ; ^{wuaiais8@yahoo.co.jp} ; Kazuhito Hirata ; MD^a ; Jun Nakazato ; MD^a ; Nobuhito Yagi ; MD^a ; Takanori Takahashi ; MD^a ; Minoru Wake ; MD^a ; Hiroshi Yasumoto ; MD^b ; Toshiho Tengan ; MD^b ; Hidemitsu Mototake ; MD^b
• 关键词：Prosthetic valve endocarditis ; Left ventricular pseudoaneurysm ; Mitral valve prosthesis ; Electrocardiography-gated computed tomography
• 刊名：Journal of Cardiology Cases
• 出版年：2013
• 出版时间：July, 2013
• 年：2013
• 卷：8
• 期：1
• 页码：e27-e30
• 全文大小：1110 K

文摘

We report a case of infective endocarditis complicated with left ventricular pseudoaneurysm originating from the posterior annulus of the prosthetic mitral valve in a 56-year-old woman. Despite prolonged antibiotic treatment, transesophageal echocardiography (TEE) showed partial detachment of the prosthesis from the posterior mitral annulus. Three-dimensional rotational computed tomography clearly demonstrated a pseudoaneurysm toward the posterolateral portion of the mitral prosthetic valve, which was not evident by TEE. Valve replacement and repair of the pseudoaneurysm were performed 83 days after initiation of antibiotic therapy. Left ventricular pseudoaneurysm is a rare but serious complication of mitral prosthetic valve endocarditis. It requires prompt diagnosis and early surgical intervention.

<Learning objective: We present a case of infective endocarditis (IE) complicated with left ventricular pseudoaneurysm originating from the prosthetic mitral valve. Repeated transesophageal echocardiography is recommended for all IE patients when perivalvular extension is suspected. Electrocardiography-gated three-dimensional-computed tomography is useful for detection and evaluation of pseudoaneurysm, especially in planning surgical procedures.>