Angina caused by systolic compression of the left coronary artery as a result of pseudoaneurysm of the mitral-aortic intervalvular fibrosa

A mitral-aortic intervalvular fibrosa false aneurysm in a patient without overt heart disease

“…Surgical therapy in an asymptomatic patient may seem to be somewhat confusing. However, left ventricular mitral-aortic intervalvular fibrosa false aneurysms have catastrophic complications, such as compression of the coronary arteries (which causes angina [4]), cardiac tamponade (resulting from rupture into the pericardial sac [5]) and mitral regurgitation (resulting from rupture into the left atrium [7]). The possibility of these complications and the absence of long-term results in patients followed in conservative manner justified our choice of surgical approach.…”

“…It is frequently detected secondary to infective endocarditis and aortic valve surgery (1)(2)(3). Patients with mitral-aortic intervalvular fibrosa aneurysms have many clinical presentations, such as angina pectoris and cardiac tamponade (4,5).…”

Aneurysm of the mitral-aortic intervalvular fibrosa as a rare cause of angina pectoris: Angiographic demonstration

“…A few cases of pseudoaneurysms of the MAIF have been described in the past [1][2][3][5][6][7][8][9][10]. What differentiates a true aneurysm of the MAIF from a pseudoaneurysm is the presence of a well-defined fibrotic wall and its relatively wide orifice.…”

“…Aneurysms of the MAIF, true or pseudo, are always located on the left side of the aortic root, extending anteriorly or posteriorly and above the left atrium. The mitral-aortic intervalvular fibrosa's unique anatomic location, between the noncoronary and left coronary aortic cusps and the anterior leaflet of the mitral valve, is responsible for the relatively common involvement of coronary arteries which can cause clinical symptoms [10,12]. Those pseudoaneurysms larger than 4 cm and extending posteriorly, under the left main and circumflex coronary arteries, have been previously and presently described to compress the adjacent coronary arteries [10,12].…”

Rheumatic Mineralization of Aortic Valve and Anterior Mitral Leaflet—A Case Report

“…The mitral-aortic intervalvular fibrosa is the junctional tissue between the elements of mitral and aortic valves, called as mitral-aortic membrane or curtain. It is relatively avascular and offers little resistance to infection [2].…”