A Rare and Life-Threatening Complication of Infective Endocarditis: Pseudoaneurysm of the Mitral - Aortic Intervalvular Fibrosa

A 59 year-old previously healthy male was admitted to the hospital with fever reportedly several days in duration. His physical examination was unremarkable at first. Pneumonia was initially diagnosed, but acute pulmonary edema with a new grade III to and fro murmur developed 1 week later. Transesophageal echocardiography (TEE) disclosed a pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF). Subsequent consultation with a cardiovascular surgeon resulted in a repaired aorta with otherwise uneventful results. P-MAIVF is a very rare complication of prosthetic aortic valve (AV) infective endocarditis, and even in native AV. Therefore a careful and through physical examination of patients and early TEE examination are essential in this rare complication of infective endocarditis.