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Case Reports
. 2025 Apr 2;30(7):103501.
doi: 10.1016/j.jaccas.2025.103501.

Acquired Annular Subvalvular Aneurysm Complicated by a Fistulous Tract

Ali Hyder Nazeer  1 , Iman Mushfiq Farooqui  2 , Rizwan Alimohammad  3 , Brion Winston  4
Affiliations
Case Reports

Acquired Annular Subvalvular Aneurysm Complicated by a Fistulous Tract

Ali Hyder Nazeer et al. JACC Case Rep. .

Abstract

We report a case of an annular subvalvular left ventricular aneurysm in a 60-year-old Caucasian woman with a history of rheumatoid arthritis, hypertrophic cardiomyopathy and methicillin-resistant Staphylococcus aureus bacteremia. Initial transthoracic echocardiography failed to identify the aneurysm, but trans-esophageal echocardiography and cardiac magnetic resonance imaging confirmed the diagnosis. The patient underwent repair of left ventricular pseudoaneurysm with bovine pericardium patch and is doing well postoperatively with residual pulmonary hypertension, left ventricular intracavitary gradient, and right ventricular dysfunction.

Keywords: fistulous tract; mitral regurgitation; subvalvular aneurysm.

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Conflict of interest statement

Funding Support and Author Disclosures The authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Transesophageal Echocardiogram Still Image Showing Jets of Regurgitant Blood Flow Through the Abnormal Fistulous Cavity LA = left atrium; LV = left ventricle; SVA = subvalvular aneurysm.
Figure 2
Figure 2
Cardiac Magnetic Resonance Imaging Snapshot During Ventricular Systole Showing 2 Jets of Regurgitant Blood Flow The 2 jets of regurgitant blood flow are jet “a” LV through an opening in aneurysm, and jet “b” aneurysm through an opening in LA. Abbreviations as in Figure 1.
See this image and copyright information in PMC

References

    1. Chesler E., Mitha A.S., Edwards J.E. Congenital aneurysms adjacent to the anuli of the aortic and/or mitral valves. Chest. 1982 Sep;82(3):334–337. - PubMed
    1. Wolpowitz A., Arman B., Barnard M.S., Barnard C.N. Annular subvalvular idiopathic left ventricular aneurysms in the black African. Ann Thorac Surg. 1979;27(4):350–355. - PubMed
    1. Morais H, Feijão A, Manuel V. Annular subvalvular left ventricular aneurysms: a comprehensive review. EC Cardiology SI.02. 2020:01-13.
    1. Rawla P. Cardiac and vascular complications in rheumatoid arthritis. Reumatologia. 2019;57(1):27–36. - PMC - PubMed
    1. Corrao S., Messina S., Pistone G., Calvo L., Scaglione R., Licata G. Heart involvement in rheumatoid arthritis: systematic review and meta-analysis. Int J Cardiol. 2013;167(5):2031–2038. - PubMed

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