Left Ventricular Pseudoaneurysm Complicating Mitral Valve Replacement: Transesophageal Echocardiographic Diagnosis and Impact on Management

Left ventricular pseudoaneurysm formation after mitral valve replacement, although infrequent, is a serious complication with potential catastrophic results. We describe a case of an anterobasal pseudoaneurysm compressing all branches of the left coronary artery, which was missed by initial transthoracic echocardiography and was well characterized with the transesophageal approach. Although the pseudoaneurysm was detected at contrast ventriculography, the transesophageal study provided new specific details regarding the exact site of origin of the pseudoaneurysm and its relationship to the coronary arteries that significantly influenced planning the surgical procedure and patient management.