title: Anterior mitral valve leaflet aneurysm due to infective endocarditis detected by cardiac magnetic resonance imaging.
abstract: We report a case of mitral valve aneurysm in a 30-year-old man presenting with fatigue, malaise, and fever 10 weeks after emergent aortic valve replacement for endocarditis. The transthoracic echocardiogram demonstrated perivalvular aortic regurgitation, but no abscess cavity was defined. Cardiac magnetic resonance imaging (MRI) revealed a mitral valve leaflet aneurysm. Both aortic and mitral valves were replaced with mechanical prostheses. Pathology of the excised mitral valve showed a focally hemorrhagic aneurysm of the anterior leaflet with myxoid degeneration and focal calcification. Early diagnosis and intervention are important to treat this rare, potentially fatal complication of aortic valve endocarditis. Cardiac MRI provided an accurate and useful preoperative diagnostic evaluation.
authors.affiliation: Heart Center of Greater Cincinnati and Lindner Research Center at Christ Hospital, Cincinnati, Ohio, USA.
authors.forename: Syed
authors.initials: S
authors.lastname: Saghir
authors.forename: Tom D
authors.initials: TD
authors.lastname: Ivey
authors.forename: Dean J
authors.initials: DJ
authors.lastname: Kereiakes
authors.forename: Wojciech
authors.initials: W
authors.lastname: Mazur
mesh_terms: D000038:Abscess / Q000601:surgery; D000328:Adult; D000783:Aneurysm / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D001021:Aortic Valve / Q000601:surgery; D004452:Echocardiography; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D006350:Heart Valve Prosthesis / Q000009:adverse effects; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008943:Mitral Valve / Q000382:microbiology* / Q000601:surgery; D012086:Reoperation; D013290:Streptococcal Infections / Q000150:complications* / Q000175:diagnosis* / Q000382:microbiology / Q000601:surgery; D034361:Streptococcus mitis