Pseudoaneurysm of the mitral aortic intervalvular fibrosa

Pseudoaneurysm of the mitral aortic intervalvular fibrosa (p-MAIVF) refers to a pseudoaneurysm in the region of the avascular fibrous tissue between the mitral and aortic valves (i.e. the mitral-aortic intervalvular fibrosa (MAIVF)).

Pathology

Aetiology

They may rarely occur as a result of infective endocarditis, surgery (often aortic valve surgery), or trauma.

Radiographic features

CT

Best seen on ECG gated cardiac CT.

May be seen as a small contrast enhancing pouch like structure typically positioned between the mitral valve and the aortic root ³. It is contiguous with the left ventricular outflow tract, which can sometimes be useful in differentiating it from aortic root region abscess.

Complications

Recognised complications include:

• thromboembolism

• septic embolism

• mitral valve dysfunction

• rupture

• compression of adjacent structures, inclusive of the coronary arteries

Treatment and prognosis

It can be a life threatening condition in some situations. Surgery is often recommended although some cases have been managed conservatively ⁵.

Differential diagnosis

Possible differential considerations include:

• regional abscess - e.g. aortic root abscess