Postventriculotomy aneurysm and left ventricular dysfunction following closed mitral commissurotomy

A ventricular aneurysm at the site of a previous transventricular commissurotomy for mitral stenosis was diagnosed in a 39 year old female. Catheterization data showed abnormal left ventricular response to exercise and to increased afterload. Death occurred following mitral valve replacement. At autopsy no cause other than left ventricular aneurysm could be established to explain left ventricular dysfunction.