title: Large pseudoaneurysms of the mitral-aortic intervalvular fibrosa: long-term natural history without surgery in two patients.
abstract: A pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a well-described complication of aortic valve endocarditis and aortic valve replacement. It may occasionally cause complications, but it may also remain uncomplicated and asymptomatic for unknown periods. Although corrective surgery is commonly recommended, the appropriate therapeutic approach to this pathology is unclear. The current report describes two patients with large pseudoaneurysms of the mitral-aortic intervalvular fibrosa, who were treated conservatively without surgery without any adverse clinical events during long-term follow-up. Therefore, conservative follow-up of this pathology with echocardiographic monitoring appears to be a valid and safe alternative for surgery, especially in patients at high risk for surgical intervention.
authors.affiliation: Echocardiography Laboratory and Heart Valves Clinic, Department of Cardiology, Rambam Health Care Campus and the Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa 31096, Israel.
authors.forename: Tal
authors.initials: T
authors.lastname: Hasin
authors.forename: Shimon A
authors.initials: SA
authors.lastname: Reisner
authors.forename: Yoram
authors.initials: Y
authors.lastname: Agmon
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000473:pathology; D001022:Aortic Valve Insufficiency / Q000000981:diagnostic imaging / Q000601:surgery; D001705:Bioprosthesis / Q000009:adverse effects; D017548:Echocardiography, Transesophageal; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000175:diagnosis; D005500:Follow-Up Studies; D006322:Heart Aneurysm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000473:pathology; D008991:Monitoring, Physiologic / Q000379:methods; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors