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Poddi S, Tropea I, Faggian G, De Feo S, Zordan M, Rungatscher A. S. gallolyticus Aortic Valve Endocarditis with Mitral Valve Leaflet Aneurysm. Case Rep Cardiol 2022; 2022:3111032. [PMID: 36568525 DOI: 10.1155/2022/3111032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/26/2022] [Indexed: 12/23/2022] Open
Abstract
S. gallolyticus is one of the pathogenic agents of endocarditis, and mitral valve aneurysm is a rare but potentially devastating complication. We present a case of S. gallolyticus aortic valve endocarditis with concomitant anterior mitral valve leaflet aneurysm. Patient underwent surgery before aneurysm perforation, and postoperative course was uneventful. Time of surgery is crucial to avoid severe complications due to aneurysm rupture.
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Werner ME, Riezebos RK, Kuipers RS. A Perforated Mitral Valve Aneurysm: A Rare but Serious Complication of Aortic Valve Endocarditis Resulting From a Regurgitant Jet Lesion. Cureus 2020; 12:e11644. [PMID: 33376655 PMCID: PMC7755663 DOI: 10.7759/cureus.11644] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Infective endocarditis has high morbidity and mortality rates. The aortic valve is most often affected in native valve endocarditis. Complications of aortic valve endocarditis range from local abscess and fistula formation, systemic complications secondary to thromboembolism and septic embolization, to congestive heart failure resulting from conduction system involvement and valve damage. A rare complication of aortic valve endocarditis is the occurrence of a ‘jet lesion’ on the mitral valve. Such a lesion, caused by an impinging regurgitant jet stream from a damaged aortic valve, can become directly and indirectly inoculated and evolve into a local infected aneurysm which might eventually rupture causing acute severe congestive heart failure and/or peripheral thromboembolism. We present the case of a 63-year-old man who presented with aortic valve endocarditis complicated by a perforated mitral valve aneurysm, congestive heart failure, and peripheral thromboembolism.
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Hara L, El Hattab FZ, Radi FZ, Zarzur J, Cherti M. [Perforated posterior mitral valve aneurysm: a rare complication of infective endocarditis: a case report]. Pan Afr Med J 2019; 32:178. [PMID: 31312292 PMCID: PMC6620063 DOI: 10.11604/pamj.2019.32.178.17710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 01/15/2019] [Indexed: 11/11/2022] Open
Abstract
Mitral valve aneurysm is a rare abnormality whose pathophysiology is poorly understood. It is defined as a bulge of the mitral valve leaflet toward the left atrium. Aneurysm in the posterior leaflet is exceptional. We report the case of a 26-year old man, who had been followed up for rheumatic aortic regurgitation for 4-years, hospitalized for febrile syndrome associated with episodes of left heart failure. Transthoracic echocardiographic examination (TTE) and transesophageal echocardiography (TEE) showed aortic valve vegetations with wide aneurysm of the small mitral valve associated with severe mitral valve regurgitation. The patient underwent mitral and aortic valve replacement with simple postoperative outcome. Clinical suspicion associated with suitable preoperative imaging and early surgical treatment are essential to recognize and treat this rare complication of infectious endocard.
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Affiliation(s)
- Loubna Hara
- Service de Cardiologie B, CHU Ibn Sina, Rabat, Maroc
| | | | | | - Jamila Zarzur
- Service de Cardiologie B, CHU Ibn Sina, Rabat, Maroc
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Rogolevich VV, Glushkova TV, Ponasenko AV, Ovcharenko EA. [Infective Endocarditis Causing Native and Prosthetic Heart Valve Dysfunction]. ACTA ACUST UNITED AC 2019; 59:68-77. [PMID: 30990144 DOI: 10.18087/cardio.2019.3.10245] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2019] [Accepted: 04/13/2019] [Indexed: 11/18/2022]
Abstract
Infective endocarditis (IE) is the disease that has high inhospital mortality. Heart valves dysfunction - both native and prosthetic - is the primary IE complication requiring a surgical intervention. The IE causes and its course have been discussed in this review. In particular, the role of concomitant infectious foci in the formation and development of IE have been considered, the mechanisms of mutual transition of subacute and acute clinical forms have been described. Modern diagnostic principles and methods based on the Duke criteria system have been mentioned, as well as the difficulties that follow the patient's clinical status evaluation. The normobiotic microbiota participation, as well as the possibilities for their identification using blood culture and PCR technique, have been closely reviewed. According to modern researches and publications, there have been made the conclusion about the contribution of obligate anaerobic bacteria, fungi and viruses to the development of endocarditis. There have been described the hypothesis about the presumptive strategy for the cardiac dysfunction formation as a result of the IE causative agents cells metabolic activity based on a literature data analysis in the article: vegetation formed by Staphylococcus aureus can lead to the heart valve stenosis, and the influence of hyaluronidases, collagenases on a heart valve structure can lead to regurgitation. The pathogens cells ability to avoid the human immune system response is caused by the biofilms, fibrin vegetations formation and the enzymes production - cytotoxins (streptolysins, leukocidin, etc.). It has been suggested that the mediators of inflammation and leukocyte cells participate in the destruction of native and prosthetic tissues due to an IE pathogens inaccessibility for immunocompetent cells.
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Affiliation(s)
- V V Rogolevich
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
| | - T V Glushkova
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
| | - A V Ponasenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
| | - E A Ovcharenko
- Research Institute for Complex Issues of Cardiovascular Diseases, Kemerovo
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Moretti M, Buscaglia A, Senes J, Tini G, Brunelli C, Bezante GP. Anterior Mitral Valve Aneurysm Is an Uncommon Complication of Aortic Valve Infective Endocarditis: A Case Report. Am J Case Rep 2018; 19:1146-1151. [PMID: 30262801 PMCID: PMC6180919 DOI: 10.12659/ajcr.909922] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Patient: Male, 62 Final Diagnosis: Mitral valve aneurysm complicating aortic valve endocarditis Symptoms: Fever Medication: — Clinical Procedure: Combined aortic valve and mitral valve replacement Specialty: Cardiology
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Affiliation(s)
- Martina Moretti
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
| | - Angelo Buscaglia
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
| | - Jacopo Senes
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
| | - Giacomo Tini
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
| | - Claudio Brunelli
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
| | - Gian Paolo Bezante
- Clinic of Cardiovascular Disease, San Martino Policlinic Hospital, University of Genova, Genova, Italy
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Konishi T, Funayama N, Yamamoto T, Hotta D, Kikuchi K, Ohori K, Nishihara H, Tanaka S. Severe mitral regurgitation due to mitral leaflet aneurysm diagnosed by three-dimensional transesophageal echocardiography: a case report. BMC Cardiovasc Disord 2016; 16:234. [PMID: 27876001 PMCID: PMC5120478 DOI: 10.1186/s12872-016-0413-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 11/15/2016] [Indexed: 11/28/2022] Open
Abstract
Background A small mitral valve aneurysm (MVA) presenting as severe mitral regurgitation (MR) is uncommon. Case presentation A 47-year-old man with a history of hypertension complained of exertional chest discomfort. A transthoracic echocardiogram (TTE) revealed the presence of MR and prolapse of the posterior leaflet. A 6-mm in diameter MVA, not clearly visualized by TTE, was detected on the posterior leaflet on a three-dimensional (3D) transesophageal echocardiography (TEE). The patient underwent uncomplicated triangular resection of P2 and mitral valve annuloplasty, and was discharged from postoperative rehabilitation, 2 weeks after the operation. Histopathology of the excised leaflet showed myxomatous changes without infective vegetation or signs of rheumatic heart disease. Conclusions A small, isolated MVA is a cause of severe MR, which might be overlooked and, therefore, managed belatedly. 3D TEE was helpful in imaging its morphologic details. Electronic supplementary material The online version of this article (doi:10.1186/s12872-016-0413-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Takao Konishi
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan. .,Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
| | - Naohiro Funayama
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Tadashi Yamamoto
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Daisuke Hotta
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Kenjiro Kikuchi
- Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan
| | - Katsumi Ohori
- Department of Cardiovascular Surgery, Hokkaido Cardiovascular Hospital, Sapporo, Japan
| | - Hiroshi Nishihara
- Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
| | - Shinya Tanaka
- Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan
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Sousa MJ, Alves V, Cabral S, Antunes N, Pereira LS, Oliveira F, Silveira J, Torres S. Mitral valve aneurysm: A serious complication of aortic valve endocarditis. Rev Port Cardiol 2016; 35:621.e1-5. [DOI: 10.1016/j.repc.2016.02.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 02/06/2016] [Indexed: 11/18/2022] Open
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Sousa MJ, Alves V, Cabral S, Antunes N, Pereira LS, Oliveira F, Silveira J, Torres S. Mitral valve aneurysm: A serious complication of aortic valve endocarditis. Revista Portuguesa de Cardiologia (English Edition) 2016. [DOI: 10.1016/j.repce.2016.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tomsic A, Li WWL, van Paridon M, Bindraban NR, de Mol BAJM. Infective Endocarditis of the Aortic Valve with Anterior Mitral Valve Leaflet Aneurysm. Tex Heart Inst J 2016; 43:345-9. [PMID: 27547149 DOI: 10.14503/thij-15-5322] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Mitral valve leaflet aneurysm is a rare and potentially devastating complication of aortic valve endocarditis. We report the case of a 48-year-old man who had endocarditis of the native aortic valve and a concomitant aneurysm of the anterior mitral valve leaflet. Severe mitral regurgitation occurred after the aneurysm perforated. The patient showed no signs of heart failure and completed a 6-week regimen of antibiotic therapy before undergoing successful aortic and mitral valve replacement. In addition to the patient's case, we review the relevant medical literature.
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MESH Headings
- Adult
- Aged
- Aneurysm, Infected/diagnostic imaging
- Aneurysm, Infected/microbiology
- Aneurysm, Infected/therapy
- Aneurysm, Ruptured/diagnostic imaging
- Aneurysm, Ruptured/microbiology
- Aneurysm, Ruptured/therapy
- Anti-Bacterial Agents/administration & dosage
- Aortic Valve/diagnostic imaging
- Aortic Valve/microbiology
- Aortic Valve/surgery
- Drug Administration Schedule
- Echocardiography, Transesophageal
- Endocarditis, Bacterial/diagnostic imaging
- Endocarditis, Bacterial/microbiology
- Endocarditis, Bacterial/therapy
- Female
- Heart Aneurysm/diagnostic imaging
- Heart Aneurysm/microbiology
- Heart Aneurysm/therapy
- Heart Valve Diseases/diagnostic imaging
- Heart Valve Diseases/microbiology
- Heart Valve Diseases/therapy
- Heart Valve Prosthesis Implantation
- Humans
- Male
- Middle Aged
- Mitral Valve/diagnostic imaging
- Mitral Valve/microbiology
- Mitral Valve/surgery
- Mitral Valve Insufficiency/diagnostic imaging
- Mitral Valve Insufficiency/microbiology
- Mitral Valve Insufficiency/surgery
- Streptococcal Infections/diagnostic imaging
- Streptococcal Infections/microbiology
- Streptococcal Infections/therapy
- Streptococcus gordonii/drug effects
- Streptococcus gordonii/isolation & purification
- Treatment Outcome
- Young Adult
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Abstract
A 63-year-old man with infective endocarditis (IE) was admitted to our hospital after experiencing acute heart failure. A two-dimensional transthoracic and transesophageal echocardiography revealed vegetation attached to both aortic and mitral valves, a very large mitral valve aneurysm, a severe mitral regurgitation jet issuing from a mitral valve perforation and severe aortic regurgitation. Three days after admission, both the aortic and mitral valves were replaced. The patient received antibiotic therapy for 6 weeks postoperatively and recovered with no neurological complications. Although the patient was discharged without recurrence of IE, his transthoracic and transesophageal echocardiography showed periprosthetic mitral regurgitation, requiring him to receive close follow-up monitoring. This case report exemplifies the rather unusual, but important, complications of aortic valve IE, and suggests some suitable forms of intervention.
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Affiliation(s)
- Shoko Uematsu
- Department of Cardiology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Kyomi Ashihara
- Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan
| | - Hideyuki Tomioka
- Department of Cardiovascular Surgery, Tokyo Women's Medical University, Tokyo, Japan
| | - Atsushi Takagi
- Department of Cardiology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Japan
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Zegrí I, Moñivas V, Mingo S, Garcia-Montero C, Cavero MA. Ruptured aneurysm of anterior mitral leaflet in aortic valve infective endocarditis. Echocardiography 2014; 32:720-2. [PMID: 25365965 DOI: 10.1111/echo.12831] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Isabel Zegrí
- Echocardiography Laboratory, Department of Cardiology, Hospital Universitario Puerta de Hierro, Madrid, Spain
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12
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Zhu YB, Zhang XH, Wang LQ, Guan X. Fibrous cyst of the chordae tendineae of the mitral valve: echocardiographic appearance and literature review. Echocardiography 2014; 32:174-7. [PMID: 25251665 DOI: 10.1111/echo.12750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Fibrous cyst of the chordae tendineae of the mitral valve (MV) is defined as a fibrous cyst arising from the chordae tendineae of the MV. It is extremely rare and its etiology is not clear. We present a case of a cystic structure within the left ventricle. This structure is connected to the anterior MV leaflet and the posterior chordae tendineae. It moves freely, resulting in stenosis of inflow tract and outflow tract of the left ventricle. Intraoperative assessment and histopathologic examination revealed it as a fibrous cyst. Its echocardiographic appearance is unique and it must be resected immediately.
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Affiliation(s)
- Yan-Bo Zhu
- Division of Ultrasound, Tianjin Chest Hospital, Tianjin, China
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