Repair of a subvalvular left ventricular aneurysm following mitral valve replacement.

Left ventricular aneurysms are a frequent complication of myocardial infarction. Some aneurysms occur secondary to trauma, previous operation, or infection. This report presents the case of a patient with a posterior submitral left ventricular aneurysm, which occurred following mitral valve replacement. The complete obliteration of the pericardial sac due to previous cardiac operation and the posterior location made external dissection of the aneurysmal wall technically impossible. Closure of the defect through the valve orifice by placing a patch over the neck of the aneurysm was found to be a relatively simple and safe technique combined with replacement of the prosthetic valve. The possibility of injury to the circumflex coronary artery was reduced using this surgical approach.