PMC6057300_01
Transthoracic echocardiography showing the submitral pseudoaneurysm (A); at color Doppler, communication between the false chamber and left atrium is evident (B); transesophageal echocardiography displayed the false chamber communicating with both the left atrium and left ventricle (C, arrows); 3D transthoracic echocardiography displaying the left atrium and the false chamber (PsA) paired (D).
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fig1
Transthoracic echocardiography showed a fluid-filled chamber arising from the posterolateral wall of the left ventricle, immediately below the mitral annulus (Figures 1 and 1); through the 3D echo, the left atrium and the chamber are seen paired (Figure 1). Transesophageal echocardiography revealed a large submitral pseudoaneurysm (34 x 61 x 50 mm) communicating with left ventricle and left atrium through a single neck (Figure 1, arrows).
Cardiac magnetic resonance showing the pseudoaneurysm (A); the pseudoaneurysm (PsA) seen at contrast ventriculography (B, arrow); surgical view of the PsA before (C) and after resection (D).
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fig2
Magnetic resonance imaging (MRI) demonstrated systolic blood flow entering the pseudoaneurysm from the left ventricle and through the cavity into the left atrium (Figure 2, video). Coronary angiography showed patency of LAD stents; contrast ventriculography confirmed the large pseudoaneurysmal cavity (Figure 2, arrow). The patient was referred to surgery (Figures 2 and 2) which showed partial annular detachment as well as perforation of the posterior mitral leaflet at P1 scallop.