Tariq Muhammad, Zahid Ibrahim, Sami Shahid
Fellow Advance Complex Cardiac Surgery, St. Boniface Hospital, Winnipeg, Manitoba, Canada.
Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
J Cardiothorac Surg. 2019 Nov 27;14(1):204. doi: 10.1186/s13019-019-1032-6.
Mitral valve aneurysm (MVA) is a saccular outpouching of the mitral leaflet which expands on systole and collapses during diastole. The case of MVA was first described in 1729 by Morand. It is one of the rare entities with a reported incidence of only 0.2-0.29% and no such case reported in Pakistan before.
A 51 year old female presented with dyspnea and chest pain for 3 months. Upon investigating, trans-esophageal echocardiography (TEE) revealed thickened anterior mitral valve leaflet with rolled up margins, forming an aneurysm, with severe mitral regurgitation. Subsequently, the valve was evaluated intra-operatively for repair but eventually had to be excised and then successfully replaced with a bioprosthetic valve.
TEE is an excellent technique to confirm the diagnosis of a mitral valve leaflet aneurysm, and depending upon the severity of the defect, valve repair can be attempted but replacement becomes the most suitable treatment modality, once repair is deemed impossible. We hereby report a rare case, where timely diagnosis, appropriate surgical intervention and regular post-operative follow up helped in achieving good prognosis of this rare entity.
二尖瓣动脉瘤（MVA）是二尖瓣叶的囊状膨出，在收缩期扩张，舒张期塌陷。MVA病例于1729年由莫兰德首次描述。它是一种罕见的疾病，报告发病率仅为0.2 - 0.29%，此前巴基斯坦尚无此类病例报告。
一名51岁女性因呼吸困难和胸痛3个月前来就诊。经检查，经食管超声心动图（TEE）显示二尖瓣前叶增厚，边缘卷曲，形成动脉瘤，并伴有严重二尖瓣反流。随后，术中对瓣膜进行评估以尝试修复，但最终不得不切除，然后成功置换了生物人工瓣膜。
TEE是确诊二尖瓣叶动脉瘤的优秀技术，根据缺损的严重程度，可尝试瓣膜修复，但一旦认为无法修复，置换就成为最合适的治疗方式。我们在此报告一例罕见病例，及时诊断、适当的手术干预和定期的术后随访有助于实现这种罕见疾病的良好预后。
