Transcatheter Self-Expanding Valve with a Dual Purpose—Exclusion of a Pseudoaneurysm of the Mitral-Aortic Intervalvular Fibrosa and Treatment of Aortic Stenosis

Pseudoaneurysm of the mitral-aortic intervalvular fibrosa (P-MAIVF) is a rare condition usually acquired as previous heart surgery or endocarditis sequela. P-MAIVF can cause life-threatening complications whose treatment is currently debated, with complex surgical interventions as first choice soon after diagnosis. Trans-catheter aortic valve replacement (TAVR) with self-expanding valve (SEV) proved to be a feasible strategy to exclude a congenital P-MAIVF coexisting with a symptomatic low-flow/low-gradient (LFLG) aortic stenosis. A recapturable SEV, implanted under trans-esophageal echocardiography (TEE) guidance, can reduce the risk of valve displacement and of P-MAIVF perforation that is probably higher in balloon-expandable (BEV) implantations.