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Late-phase left ventricular pseudoaneurysm after three-time mitral valve surgery

Shinichi Ishida, Masato Mutsuga, Takashi Fujita

    Journal of Surgical Case Reports
    |January 24, 2022
    PubMed

    Insights

    Late rupture of the left ventricle posterior wall after mitral valve replacement (MVR) can cause left ventricular pseudoaneurysms (LVPAs). This case report details a successful surgical technique for repairing a LVPA during MVR in a patient with a history of endocarditis.

    Area of Science:

    • Cardiovascular Surgery
    • Cardiac Surgery
    • Adult Congenital Heart Disease

    Background:

    • Rupture of the left ventricular posterior wall is a rare but fatal complication of mitral valve replacement (MVR).
    • Late-phase rupture, occurring years after MVR, can manifest as left ventricular pseudoaneurysms (LVPAs).
    • Surgical repair of LVPAs, especially in patients with prior cardiac surgeries, presents significant challenges.

    Observation:

    • A 40-year-old male with a history of three mitral valve surgeries for infectious endocarditis was incidentally diagnosed with a symptomatic left ventricular aneurysm.
    • The patient underwent successful closure of the left ventricular pseudoaneurysm concurrently with mitral valve replacement.

    Findings:

    • This case highlights the successful surgical management of a late-onset left ventricular pseudoaneurysm in a patient with a complex cardiac history.
    • The report describes a specific surgical technique employed for the closure of the LVPA during MVR.

    Implications:

    • This successful repair demonstrates a viable approach for managing challenging LVPA cases during MVR.
    • The findings may contribute to improved surgical strategies for late complications following mitral valve surgery.
    • Further research into optimal techniques for LVPA repair in complex cases is warranted.

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