Re air of a Subvalvular Following Mitral Valve Replacement Le rt Ventricular Aneurysm

Left ventricular aneurysms are a fre- quent complication of myocardial infarction. Some aneurysms occur secondary to trauma, previous op- eration, or infection. This report presents the case of a patient with a posterior submitral left ventricular aneurysm, which occurred following mitral valve replacement. The complete obliteration of the pericardial sac due to previous cardiac operation and the posterior location made external dissection of the aneurysmal wall technically impossible. Closure of the defect through the valve orifice by placing a patch over the neck of the aneurysm was found to be a relatively simple and safe technique combined with replacement of the prosthetic valve. The possi- bility of injury to the circumflex coronary artery was reduced using this surgical approach. Left ventricular aneurysm is a frequently made diagnosis in the present era of high interest in coronary artery disease and the complications of myocardial ischemia (l-41. There are two types of left ventricular aneurysm not caused by ischemic heart disease. One idiopathic type is limited in occurrence almost exclusively to Afri- can Blacks (5). The other variety, which may be a complication of previous cardiac operation or infection, is not recognized very often (6). The present report concerns surgical repair of a sub- valvular left ventricular aneurysm that occurred after mitral valve replacement.