Infective Endocarditis Complicated by Mitral Valve Aneurysm: Pathologic and Echocardiographic Correlations.
Infective endocarditis is a well-described cardiovascular disease that causes significant morbidity and mortality despite medical and surgical advances. Complications of endocarditis include heart failure, systemic embolization, and valvular destruction including valve aneurysms which increase morbidity and mortality. Mitral valve aneurysms are rarely encountered in the clinical setting. We present eight mitral valve aneurysm cases and discuss a new potential pathogenesis of this deadly endocarditis complication. Pathologic evaluation suggests that neovascularization of the anterior mitral valve leaflet predisposes this territory to abscess and aneurysm formation. In conclusion, mitral valve aneurysms appear to be another form of intravalvular abscess which has expanded and should be approached aggressively with surgical intervention if indicated.
Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky Medical Center, Lexington, Kentucky.
Arash
A
Seratnahaei
Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky Medical Center, Lexington, Kentucky.
Alison L
AL
Bailey
Department of Pathology, University of Kentucky Medical Center, Lexington, Kentucky.
Patrick J
PJ
Hensley
Department of Pathology, University of Kentucky Medical Center, Lexington, Kentucky.
William
W
O'Connor
Division of Cardiovascular Medicine, Gill Heart Institute, University of Kentucky Medical Center, Lexington, Kentucky.
Mikel D
MD
Smith
D000328:Adult; D000368:Aged; D000785:Aneurysm, Infected / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D004697:Endocarditis, Bacterial / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D008297:Male; D008943:Mitral Valve / Q000000981:diagnostic imaging / Q000382:microbiology / Q000601:surgery; D014463:Ultrasonography; D055815:Young Adult
echocardiography; infective endocarditis; mitral valve aneurysm