The use of three-dimensional echocardiography in the visualization of pseudoaneurysm of the mitral-aortic intervalvular fibrosa.

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (MAIF) is an uncommon but serious complication of aortic valve endocarditis. A 23-year-old woman was referred to our institution with the diagnosis of aortic valve endocarditis thought to be complicated by an aortic root abscess. Two-dimensional transthoracic echocardiography revealed a vegetation attached to the left coronary cuspis of the aortic valve and a false aneurysm-like structure in the MAIF at the left ventricular outflow tract. The diagnosis of MAIF pseudoaneurysm was confirmed by three-dimensional echocardiography. The patient died a few hours after admission because of worsening of her neurological status. An abscess-like structure detected in a patient with aortic valve endocarditis should be differentiated from a pseudoaneurysm of the MAIF.