JACC. Case reports · 2026
"Flying Saucer"-Like Morphology in Infective Endocarditis Arising on a Stenotic Mitral Valve.
Клинический случайСтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
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История · было → стало
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Iitsuka Hiroki, Yoshida Jun, Yoshii Akira, Tsujimoto Takanori, Nakamura Mayo, Yoshimura Michihiro, Kunihara Takashi, Tokuda Michifumi
Аннотация
BACKGROUND: Infective endocarditis arising on a stenotic mitral valve is uncommon, and it may present with atypical morphology.
CASE SUMMARY: We report a case of infective endocarditis in a patient with mild to moderate degenerative mitral stenosis who developed an extensive, broad-based vegetation nearly occluding the mitral valve, with an overlying contiguous aneurysm-like cystic structure. Transthoracic echocardiography demonstrated an elevated transmitral gradient, while transesophageal echocardiography revealed hemodynamic communication between the cystic structure and the left ventricle. Computed tomography showed contrast enhancement within the cavity. Three-dimensional transesophageal echocardiography was crucial in delineating the en face morphology and extent of the obstruction. The surgical and pathological findings confirmed a flat vegetation with pseudoaneurysmal features.
DISCUSSION: This high-risk morphology warrants urgent surgical consideration, as aneurysmal rupture could precipitate acute mitral regurgitation superimposed on obstruction.
TAKE-HOME MESSAGE: With the increasing prevalence of degenerative mitral stenosis, recognition of such morphologies is essential to guide timely surgical intervention.
CASE SUMMARY: We report a case of infective endocarditis in a patient with mild to moderate degenerative mitral stenosis who developed an extensive, broad-based vegetation nearly occluding the mitral valve, with an overlying contiguous aneurysm-like cystic structure. Transthoracic echocardiography demonstrated an elevated transmitral gradient, while transesophageal echocardiography revealed hemodynamic communication between the cystic structure and the left ventricle. Computed tomography showed contrast enhancement within the cavity. Three-dimensional transesophageal echocardiography was crucial in delineating the en face morphology and extent of the obstruction. The surgical and pathological findings confirmed a flat vegetation with pseudoaneurysmal features.
DISCUSSION: This high-risk morphology warrants urgent surgical consideration, as aneurysmal rupture could precipitate acute mitral regurgitation superimposed on obstruction.
TAKE-HOME MESSAGE: With the increasing prevalence of degenerative mitral stenosis, recognition of such morphologies is essential to guide timely surgical intervention.