Bicuspid aortic valve endocarditis complicated with aortic valve aneurysm and pseudoaneurysm of the mitral-aortic intervalvular fibrosa.

摘要

A 29-year-old, previously healthy man was admitted with a 2-month history of fatigue and dyspnea. Cardiac examination disclosed a diastolic murmur at the left sternal border. Transthoracic echocardiography revealed a sac-cular structure on the aortic valve with eccentric jet of severe aortic regurgitation. Trans-esophageal echocardiography (TEE) revealed bicuspid aortic valve without any vegetation. One of the cusps showed diastolic bulging through the left ventricle, causing malcoapta-tion of the aortic valve and as a consequencesevere aortic regurgitation. Protruding of the cusp was also seen into the aorta during systole (Figs. 1A and B, arrows at the bottom; Fig. 2A, arrow). The short-axis view demonstrated the aortic valve to be typical bicuspid valve with conjoined right and left coronary cusps and a saccular aneurysm of the valve as a halo sign, originating from the right/anterior cusp (Fig. 3A, asterisk).