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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care

Official Journal of the Italian Society of Anesthesiology, Analgesia, Resuscitation and Intensive Care
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Minerva Anestesiologica 2010 May;76(5):378-80

language: English

The “Mickey Mouse” aortic root: a peculiar transesophageal echo finding

Guarracino F., Pratali S., Baldassarri R., Bortolotti U.

1 Unit of Cardiothoracic Anesthesia and Intensive Care Medicine, University Hospital of Pisa, Pisa, Italy;
2 Unit of Cardiac Surgery, Cardiothoracic Department, University Hospital of Pisa, Pisa, Italy


In the setting of aortic valve regurgitation, aortic valve incompetence can be caused by several mechanisms. Dilatation of a sinus of Valsalva is one possible cause of severe aortic valve regurgitation. Transesophageal echocardiography provides useful information for planning aortic root surgery by accurately describing the functional anatomy and mechanism of aortic valve dysfunction. The dilatation of a sinus of Valsalva can be easily seen in a two-dimensional short axis view of the aortic valve. When dilatation of the right sinus of Valsalva is present, the transesophageal echo view shows that the aortic root has a peculiar appearance, resembling the profile of Mickey Mouse. We suggest that a typical Mickey Mouse aspect of the aortic root, seen by transesophageal echocardiography, should prompt the recognition of dilatation of the right sinus of Valsalva as a mechanism of aortic valve dysfunction and lead to the appropriate reparative surgical technique.

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