Aneurysm of the anterior leaflet of the mitral valve secondary to aortic valve endocarditis

Aneurysm of the anterior mitral leaflet is a rare complication of infective aortic valve endocarditis, the natural evolution of which is generally its rupture, with subsequent acute and severe mitral regurgitation. Its presen ce cannot be recognized with transthoracic echocardiography and even in sur gery. We describe a 78-year-old man with aortic valve endocarditis, in whom transesophageal echocardiography was essential for the diagnosis of this c omplication, its therapeutic management, and the postoperative follow-up af ter simple valve repair In addition, the most appropriate surgical approach is discussed.