Mitral-aortic intervalvular fibrosa pseudoaneurysm with rupture into the left atrium: a three-dimensional trans-esophageal echocardiographic approach

Mitral-aortic intervalvular fibrosa (MAIVF) pseudoaneurysm is detected by echocardiography as a pulsatile structure at the mitral-aortic junction near the left ventricular outflow tract. Depending upon the severity of fistulization into the left atrium, acute mitral deficiency like clinical conditions may develop (1). Aortic valve endocarditis is the most commonly known etiological condition (2). Although both transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE) have proven to be valuable in diagnosis and management of the condition, the three-dimensional (3-D) TEE approach has the potential to provide important clues that may prove crucial for the management of MAIVF pseudoaneurysm.