title: 3D echocardiographic delineation of mitral-aortic intervalular fibrosa pseudoaneurysm caused by bicuspid aortic valve endocarditis.
abstract: Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a rare complication of infective endocarditis of the aortic valve eventually resulting in coronary artery compression, stroke or rupture into the left atrium, aorta or pericardial space. A prompt diagnosis by either transthoracic or transesophageal echocardiography is mandatory to address the patient to cardiac surgery. We report the clinical case of a 25-year-old white man who was admitted to the emergency department for dyspnoea and fever. Echocardiographic examination showed a bicuspid aortic valve with a huge sessile vegetation and a pseudaneurysm of the mitral-aortic intervalvular fibrosa. In addition to conventional two-dimensional examination, three-dimensional echocardiography provided additional information of this complication, precisely delineating the lesions and addressing the cardiac surgeon in choosing the most appropriate operating strategy. Patient underwent then aortic root replacement and the pseudoaneurysm was closed by means of a bovine pericardial patch.
authors.affiliation: Coronary Care Unit, Department of Cardiovascular and Respiratory Sciences, Sapienza University of Rome, Italy. stefano.caselli@uniroma1.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Caselli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Mazzesi
authors.forename: Luigi
authors.initials: L
authors.lastname: Tritapepe
authors.forename: Antonio
authors.initials: A
authors.lastname: Barretta
authors.forename: Natesa G
authors.initials: NG
authors.lastname: Pandian
authors.forename: Luciano
authors.initials: L
authors.lastname: Agati
authors.forename: Francesco
authors.initials: F
authors.lastname: Fedele
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000175:diagnosis* / Q000209:etiology* / Q000601:surgery; D000818:Animals; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology*; D002417:Cattle; D019560:Echocardiography, Three-Dimensional; D004635:Emergency Medicine; D004696:Endocarditis / Q000150:complications* / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology*