title: Intervalvular fibrosa pseudoaneurysm with projectile shunt flow to left atrium.
abstract: We report a case of intervalvular fibrosa pseudoaneurysm, causing massive shunt flow from the left ventricle below the left coronary cusp to the left atrium above the anterior mitral annulus, which was clearly demonstrated on preoperative three-dimensional transesophageal echocardiography. Superior extension of the right-sided left atriotomy toward the pseudoaneurysm, combined with transection of aorta and main pulmonary artery, provided its sufficient exposure. Its opening to the left ventricle was closed with a patch, leaving no residual shunt flow.
authors.affiliation: Department of Cardiovascular Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima City, Kagoshima 890-8520, Japan. tueno@m.kufm.kagoshima-u.ac.jp
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Ueno
authors.forename: Ryuzo
authors.initials: R
authors.lastname: Sakata
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Iguro
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001011:Aorta / Q000601:surgery; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D001705:Bioprosthesis; D006348:Cardiac Surgical Procedures; D003326:Coronary Circulation; D017548:Echocardiography, Transesophageal; D004696:Endocarditis / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D006325:Heart Atria / Q000503:physiopathology; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation; D006352:Heart Ventricles / Q000503:physiopathology; D006439:Hemodynamics; D006801:Humans; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D010496:Pericardium / Q000637:transplantation; D011651:Pulmonary Artery / Q000601:surgery; D014182:Transplantation, Autologous; D016896:Treatment Outcome