A case of pseudoaneurysm of the mitral-aortic intervalvular fibrosa in a pediatric patient.

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa is a rare and potentially deadly aberrance of the cardiac architecture, with few reported pediatric cases. Complications can include rupture into the pericardium, ongoing infective endocarditis, arrhythmias, valvular dysfunction, thrombus formation, and compression of the coronary arteries. Although there have been cases which have gone solely with surveillance, the majority of these cases will have surgical intervention to reduce the risk of complications. We present a case in a pediatric patient with a history of bicuspid aortic valve, who presented with recurrent fevers after a dental procedure despite treatment with antibiotics. Infective endocarditis was suspected based on clinical exam, and imaging revealed pseudoaneurysm of the mitral-aortic intervalvular fibrosa. The patient was treated with surgical resection and homograft replacement.