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Left ventricular sub-valvar mitral aneurysms.

Henning J Du Toit1, Ulrich O Von Oppell, John Hewitson

  • 1Chris Barnard Division of Cardiothoracic Surgery, University of Cape Town, Cape Town, South Africa.

Interactive Cardiovascular and Thoracic Surgery
|August 3, 2007
PubMed
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Sub-mitral aneurysms, though often congenital, can involve the entire posterior annulus and may be linked to rheumatic heart disease or tuberculosis. Surgical repair requires understanding the aneurysm-mitral valve relationship, with reoperation needed in 33.3% of cases.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Pathology
  • Medical Research

Background:

  • Sub-mitral aneurysms are rare cardiac conditions.
  • Previous literature has not described aneurysmal involvement of the entire posterior mitral annulus.
  • The etiology of sub-mitral aneurysms is often considered congenital.

Purpose of the Study:

  • To retrospectively review the surgical treatment of sub-mitral aneurysms.
  • To classify sub-mitral aneurysms based on posterior mitral annular involvement.
  • To investigate potential associations between sub-mitral aneurysms and other cardiac pathologies.

Main Methods:

  • Retrospective review of 12 patients (1991-2002) with sub-mitral aneurysms.
  • Classification into three groups based on posterior mitral annular involvement.

Related Experiment Videos

  • Analysis of surgical approaches, outcomes, and histological findings.

    • Main Results:

    • Identified three distinct groups based on aneurysm involvement of the posterior mitral annulus, including a previously undescribed involvement of the entire annulus.
    • No operative mortality observed.
    • Mitral valve repair initially successful in 8 patients, with 33.3% requiring reoperation due to aneurysm closure failure.
    • Histology revealed rheumatic heart disease or tuberculosis in 33.3% of patients.

    Conclusions:

    • Aneurysmal involvement of the entire posterior mitral annulus is a distinct entity.
    • Sub-mitral aneurysms may have associations with rheumatic heart disease and tuberculosis, challenging the solely congenital etiology.
    • Successful surgical repair necessitates a thorough understanding of the aneurysm's relationship with the mitral valve.