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Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa: A Complication Following Aortic Valvuloplasty

Ryoko Arakaki1, Nobuhisa Ohno1, Akira Marui1

  • 1Department of Cardiovascular Surgery, Kokura Memorial Hospital, Kitakyushu, Fukuoka 802-8555, Japan.

Interdisciplinary Cardiovascular and Thoracic Surgery
|March 12, 2026
PubMed
Abstract

Insights

Pseudoaneurysms of the mitral-aortic intervalvular fibrosa (P-MAIF) can occur after aortic valve surgery. A case report highlights a P-MAIF caused by suture material, successfully treated with patch closure and valve replacement.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Surgery
  • Surgical Complications

Background:

  • Pseudoaneurysms of the mitral-aortic intervalvular fibrosa (P-MAIF) are rare complications.
  • They are typically associated with aortic or mitral valve surgery.

Purpose of the Study:

  • To present a unique case of P-MAIF.
  • To discuss the etiology and management of P-MAIF.

Main Methods:

  • A case of P-MAIF occurring 8 months post-aortic valvuloplasty with external suture annuloplasty is described.
  • Intraoperative findings identified an expanded polytetrafluoroethylene (ePTFE) suture knot penetrating the mitral-aortic intervalvular fibrosa.
  • The P-MAIF was managed with bovine pericardium patch closure and aortic valve replacement.

Main Results:

  • The patient experienced no recurrence of P-MAIF three years post-operatively.
  • Successful surgical management of P-MAIF was achieved.

Conclusions:

  • Understanding mitral-aortic intervalvular fibrosa anatomy is crucial for prevention.
  • Precise suturing techniques and gentle tissue handling are essential during aortic and mitral valve surgery to prevent P-MAIF.
Keywords:
aortic valvuloplastyexternal suture annuloplastymitral-aortic intervalvular fibrosapseudoaneurysms

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