Rosario Chieppa Domenico Riccardo, Scardigno Antonio Davide, Deluca Giovanni, Capodivento Saverio, Quinto Nicola, Cicala Mariangela
U.O. Cardiologia, Ospedale Civile Vittorio Emanuele II, Bisceglie (BT).
U.O. Radiologia, Ospedale Civile Vittorio Emanuele II, Bisceglie (BT).
G Ital Cardiol (Rome). 2017 Jun;18(6):525-528. doi: 10.1714/2700.27614.
Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIVF-P) is one of the rare complications of endocarditis or, more rarely, of surgical trauma. This condition is characterized by a pseudoaneurysm in the intra-annular area between the mitral valve and the aortic valve communicating with the outflow tract of the left ventricle, between the coronary or noncoronary left aortic valve and the front flap of the mitral valve. Nowadays, surgery is recommended to avoid further growth and complications. We hereby describe the case of a patient with MAIVF-P as a consequence of a surgical trauma and early appearance of MAIVF-P. During the long echocardiographic and clinical follow-up, the patients showed stable clinical and hemodynamic conditions despite the increase in size of the MAIVF-P. A conservative treatment based on a medical follow-up can represent an alternative in patients refusing surgery, in high-risk surgical patients as well as in patients showing a stable echocardiographic and clinical picture regardless of the MAIVF-P size.
二尖瓣 - 主动脉瓣间纤维三角假性动脉瘤（MAIVF - P）是心内膜炎罕见的并发症之一，手术创伤导致的则更为罕见。这种情况的特征是二尖瓣和主动脉瓣之间的瓣环内区域出现假性动脉瘤，与左心室流出道相通，位于左冠状动脉或无冠状动脉主动脉瓣与二尖瓣前叶之间。如今，建议进行手术以避免进一步增大和出现并发症。我们在此描述一例因手术创伤导致MAIVF - P且MAIVF - P早期出现的患者病例。在长期的超声心动图和临床随访中，尽管MAIVF - P大小增加，但患者的临床和血流动力学状况保持稳定。对于拒绝手术的患者、高风险手术患者以及无论MAIVF - P大小超声心动图和临床表现均稳定的患者，基于医学随访的保守治疗可能是一种替代方案。
