PMC5885047_01
Parasternal short-axis view of the sub-aortic (SA) aneurysm (white arrow, left). Apical three-chamber views depicting the SA aneurysm (white arrow, middle), and an eccentric aortic regurgitation jet on colour flow, with flow into the SA aneurysm (right).
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F1
A transthoracic echocardiogram (TTE) revealed a dilated LV with an ejection fraction of 56% and moderate-to-severe eccentric aortic regurgitation secondary to leaflet malcoaptation (Fig. 1).
Left ventricular outflow tract views showing the subaortic aneurysm (blue arrow) compressing the left atrium (red arrow, left) and sparing the left coronary artery (right).
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F2
Due to suboptimal imaging on TTE and TEE, a cardiac MRI was requested to confirm the SA aneurysm and to define with certainty its relationship to the surrounding structures (Fig. 2).
Left ventricular outflow tract (left) and short-axis views (right) depicting compression of the left atrium (blue arrow) by the sub-aortic aneurysm (red arrow).
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F3
A 30 x 14-mm aneurysm with a 12-mm neck was noted below the aortic valve, which extended to the LA roof (Fig. 3).
Left ventricular outflow tract MRI image showing an aortic regurgitant jet (arrow) secondary to retraction of the left coronary cusp by the sub-aortic aneurysm.
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F4
AR of moderate severity was noted (Fig. 4).