The mitral-aortic intervalvular fibrosa (MAIVF) is the thin avascular fibrous structure located between the left side of the non-coronary cusp, the left coronary cusp and the anterior mitral leaflet. MAIVF pseudoaneurysm typically results as a complication of endocarditis, aortic valve surgery or chest trauma. We present a case of an incidental MAIF pseudoaneurysm in a 68-year female with a history of rheumatic fever without involvement of the mitral apparatus. We also discuss the presentation, evaluation and management of this rather rare valvular disorder.

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