Endoscopic repair for left ventricular pseudoaneurysm with right minithoracotomy

Left ventricular pseudoaneurysm (LVPA) is a known serious complication of myocardial infarction or mitral valve replacement. As an alternative option, transmitral patch repair for LVPA has been reported. However, it is very difficult to complete the procedure for LVPA with a large defect. A 68-year old man with a history of inferior myocardial infarction had undergone mitral valve repair. At 4 months after surgery, the presence of a giant LVPA in the posteroinferior left ventricular wall was revealed. We performed transmitral patch repair through minithoracotomy under a three-dimensional videoscope. Since the intracardiac operation was performed under only camera vision, the perspective supplied by the three-dimensional videoscope was very useful. Endoscopic patch repair was a much less invasive procedure, and we could obtain a great intracardiac view. This technique can be an appropriate option for the treatment of LVPA after cardiac surgery.