Echocardiography-Guided Successful Off-Pump Submitral Aneurysm Repair With Coronary Artery Bypass

Submitral aneurysm is a challenging and uncommon cardiac disease that is uniquely related to the posterior mitral valve leaflet. Awareness and prompt identification are vital because of the strong predilection for sudden fatal complications. Techniques and timing of surgical procedures are not standardized, especially in incidentally detected cases. We describe a submitral aneurysm in a 66-year-old woman that was incidentally diagnosed on echocardiography during a coronary artery bypass operation. This aneurysm was successfully managed through an off-pump extracardiac approach under transesophageal echocardiographic guidance. Native mitral valve function was preserved, with no residual aneurysm on follow-up.