title: Severe mitral regurgitation due to mitral leaflet aneurysm diagnosed by three-dimensional transesophageal echocardiography: a case report.
abstract: A small mitral valve aneurysm (MVA) presenting as severe mitral regurgitation (MR) is uncommon.
  
  
  
  A 47-year-old man with a history of hypertension complained of exertional chest discomfort. A transthoracic echocardiogram (TTE) revealed the presence of MR and prolapse of the posterior leaflet. A 6-mm in diameter MVA, not clearly visualized by TTE, was detected on the posterior leaflet on a three-dimensional (3D) transesophageal echocardiography (TEE). The patient underwent uncomplicated triangular resection of P2 and mitral valve annuloplasty, and was discharged from postoperative rehabilitation, 2 weeks after the operation. Histopathology of the excised leaflet showed myxomatous changes without infective vegetation or signs of rheumatic heart disease.
  
  
  
  A small, isolated MVA is a cause of severe MR, which might be overlooked and, therefore, managed belatedly. 3D TEE was helpful in imaging its morphologic details.
authors.affiliation: Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan. takaokonishi0915@gmail.com.|Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan. takaokonishi0915@gmail.com.
authors.forename: Takao
authors.initials: T
authors.lastname: Konishi
authors.affiliation: Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan.
authors.forename: Naohiro
authors.initials: N
authors.lastname: Funayama
authors.affiliation: Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan.
authors.forename: Tadashi
authors.initials: T
authors.lastname: Yamamoto
authors.affiliation: Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hotta
authors.affiliation: Department of Cardiology, Hokkaido Cardiovascular Hospital, 1-30, West 13, South 27, Chuou-ku, Sapporo, 064-8622, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Cardiovascular Surgery, Hokkaido Cardiovascular Hospital, Sapporo, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Ohori
authors.affiliation: Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nishihara
authors.affiliation: Department of Cancer Pathology, Hokkaido University, Graduate School of Medicine, Sapporo, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Tanaka
mesh_terms: D000783:Aneurysm / Q000150:complications / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D018618:Echocardiography, Doppler, Color; D019560:Echocardiography, Three-Dimensional; D017548:Echocardiography, Transesophageal; D019918:Heart Valve Prosthesis Implantation; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery; D058386:Mitral Valve Annuloplasty; D008944:Mitral Valve Insufficiency / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008945:Mitral Valve Prolapse / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Case report; Mitral leaflet aneurysm; Mitral regurgitation; Three-dimensional transesophageal echocardiography