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Congenital aneurysm of the aortomitral intervalvular fibrosa

Dingchao He1, Pranava Sinha1, Laura Olivieri2

  • 1Division of Cardiac Surgery, Children's National Medical Center, Washington, DC.

The Annals of Thoracic Surgery
|January 4, 2015
PubMed

Insights

Congenital left ventricular outflow tract (LVOT) aneurysm and subaortic stenosis in a child were successfully treated with aneurysm plication, stenosis resection, and septal myectomy. This case highlights effective surgical management for complex pediatric cardiac defects.

Area of Science:

  • Cardiovascular Surgery
  • Pediatric Cardiology
  • Congenital Heart Disease

Background:

  • Congenital left ventricular outflow tract (LVOT) aneurysm, particularly of the intervalvular fibrosa, is a rare condition.
  • Left ventricular outflow tract obstruction can occur secondary to other congenital cardiac anomalies or surgical repairs.
  • Aortic coarctation is a common congenital heart defect requiring surgical intervention.

Observation:

  • A 5-year-old boy presented with a congenital LVOT aneurysm, LVOT obstruction post-ventricular septal defect repair, and aortic coarctation.
  • The patient exhibited complex cardiac anatomy requiring multi-stage surgical consideration.

Findings:

  • Successful surgical management included plication of the LVOT aneurysm.
  • Resection of fibrous subaortic stenosis and septal myectomy were performed to relieve obstruction.
  • The combined surgical approach effectively addressed the multiple cardiac anomalies.

Implications:

  • This case demonstrates the feasibility of surgical correction for complex congenital LVOT aneurysms and associated obstructions.
  • Effective management strategies can improve outcomes for pediatric patients with intricate cardiac malformations.
  • Further research into long-term outcomes for such complex repairs is warranted.

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