PMC5368457_01
a-b. (a) Two-dimensional echocardiography of MAIVF pseudoaneurysm. (b) Eccentric turbulent flow secondary to fistulization into the left atrium.AO - aorta; AMVL - anterior mitral valve leaflet; MAIVF - mitral-aortic intervalvular fibrosa; LA - left atrium; LV - left ventricle
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F1
Additionally, an aneurysm image at the MAIVF area and an eccentric turbulent flow secondary to fistulization from the same toward the posterolateral side of the left atrium were also observed (Fig. 1a, b; Video 1).
a-b. (a) Two-dimensional transesophageal echocardiography of MAIVF pseudoaneurysm. (b) Pseudoaneurysm cavity filled with aortic regurgitationAO - aorta; LA - left atrium; LV - left ventricle; RV - right ventricle
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F2
Using TEE, an aneurysm with a dimension of 0.9 x 2.0 cm was detected at the MAIVF area (Fig. 2a, b; Video 2).
a, b, c. (a) Three-dimensional transesophageal echocardiographic view of the aortic valve in systole (b). Diastolic MAIVF bulging. (c). En face view of the mitral valve from the left atrium AO - aorta; AMVL - anterior mitral valve leaflet; MAIVF - mitral-aortic intervalvular fibrosa; PMVL - posterior mitral valve leaflet
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F3
There was no detectable structural defect of the anterior mitral valve leaflet (Fig. 3a-c; Video 3).
a, b. Transthoracic echocardiography after surgical repair. (a) Apical four-chamber view of patch. (b) Parasternal long-axis view of the prosthetic aortic valve and patch AVR - aortic valve replacement; LA - left atrium; LV - left ventricle; RA - right atrium
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F4
MAIVF pseudoaneurysm from the left atrium to aortic root was restored using bovine pericardium, and aortic valve replacement was also performed (Fig. 4a, b; Video 4).