{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T14:47:39Z","timestamp":1778510859327,"version":"3.51.4"},"reference-count":38,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:00:00Z","timestamp":1612569600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background: Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is an unusual complication related to various injuries or conditions which involve the mitro-aortic region; it communicates with the left ventricular outflow tract and is associated with a high-risk of redoubtable complications or sudden death. The cerebral and splenic localizations are frequently seen as manifestations of systemic embolism in infective endocarditis. Currently, there are no specific recommendations related to the diagnosis, management, treatment, or further evolution of patients with P-MAIVF and concomitant splenic infarction. This paper presents the case of a 43-year-old Caucasian woman with a late diagnosis of mixed bicuspid aortic valve disease, affected by an under-detected and undertreated episode of infective endocarditis leading to asymptomatic P-MAIVF. Prime clinical and imagistic diagnosis of splenic infarction indicated further extended investigations were required to clarify the source of embolism. Methods: Integrated multimodality imaging techniques confirmed the unexpected diagnosis of P-MAIVF. Results: The case had a fatal outcome following an uncomplicated yet laborious cardiac surgery. Patient death was attributed to a malignant ventricular arrhythmia. Conclusion: The present case raises awareness by highlighting an unexplained and unexpected splenic infarction association with P-MAIVF as a result of infective endocarditis related to mixed bicuspid aortic valve disease.<\/jats:p>","DOI":"10.3390\/diagnostics11020251","type":"journal-article","created":{"date-parts":[[2021,2,8]],"date-time":"2021-02-08T20:51:51Z","timestamp":1612817511000},"page":"251","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Native Aortic Valve Endocarditis Complicated by Splenic Infarction and Giant Mitral-Aortic Intervalvular Fibrosa Pseudoaneurysm\u2014A Case Report and Brief Review of the Literature"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6395-9476","authenticated-orcid":false,"given":"Andreea","family":"Varga","sequence":"first","affiliation":[{"name":"Department ME2, Faculty of Medicine in English, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Cardiology II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3828-1499","authenticated-orcid":false,"given":"Ioan","family":"Tilea","sequence":"additional","affiliation":[{"name":"Department of Cardiology II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"},{"name":"Department M4, Clinical Sciences, Faculty of Medicine, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristina Maria","family":"Tatar","sequence":"additional","affiliation":[{"name":"Department M4, Clinical Sciences, Faculty of Medicine, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragos Gabriel","family":"Iancu","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"},{"name":"Doctoral School, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria Andrada","family":"Jiga","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"},{"name":"Doctoral School, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert Adrian","family":"Dumbrava","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania"},{"name":"Doctoral School, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5324-9780","authenticated-orcid":false,"given":"Marian","family":"Pop","sequence":"additional","affiliation":[{"name":"Department ME1, Faculty of Medicine in English, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Department of Radiology and Medical Imaging, The Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2390-4291","authenticated-orcid":false,"given":"Horatiu","family":"Suciu","sequence":"additional","affiliation":[{"name":"Department M3, Clinical and Surgery Sciences, Faculty of Medicine, \u201cG. E. Palade\u201d University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania"},{"name":"Cardiac Surgery Clinic, The Emergency Institute for Cardiovascular Diseases and Transplantation, 540136 Targu Mures, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,2,6]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.4103\/jcecho.jcecho_28_19","article-title":"Normal values of the mitral-aortic intervalvular fibrosa thickness: A multimodality study","volume":"29","author":"Cresti","year":"2019","journal-title":"J. Cardiovasc. Echogr."},{"key":"ref_2","first-page":"37","article-title":"Morphological study of the human mitral-aortic intervalvular fibrosa","volume":"22","author":"Cavalcanti","year":"2005","journal-title":"J. Morphol. 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