Delayed Manifestations of a Case of Blunt Chest Wall Trauma‐Induced Pseudoaneurysm of the Mitral‐Aortic Intervalvular Fibrosa: A Case Report and Literature Review

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Abstract
Pseudoaneurysm of the mitral‐aortic intervalvular fibrosa (P‐MAIVF) is a rare condition resulting from dehiscence of the mitral‐aortic intervalvular fibrosa (MAIVF), leading to the formation of a sac communicating with the left ventricular outflow tract (LVOT). P‐MAVIF is caused mainly by infective endocarditis (IE) or trauma during medical procedures. Only six cases of blunt chest wall trauma‐induced P‐MAIVF have been reported, and our case is the first to report its long‐term complications. A 32‐year‐old man is reported with a history of a motorcycle accident that was referred due to a to‐and‐fro murmur. The echocardiographic evaluation one year after the accident revealed P‐MAIVF, and the patient was advised to undergo an operation, but he refused. Three years later, he returned with New York Heart Association (NYHA) class III dyspnea associated with orthopnea. A new transesophageal echocardiogram (TEE) confirmed a large P‐MAIVF with a dilated, dysfunctional left ventricle (LV). At this time, the patient underwent surgical intervention, and six months after the operation, he became asymptomatic, and cardiac function returned to normal. Our case is the first to report a long‐term complication of a blunt chest wall trauma‐induced P‐MAIVF, and our findings once again confirm the fact that early surgery and repair are a wise and appropriate decision for such patients.
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  • Shiraz University of Medical Sciences

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