Postoperative false aneurysm of left ventricle and obstruction of left circumflex coronary artery complicating enlargement of restrictive ventricular septal defect in double-outlet right ventricle.

A case is reported of double-outlet right ventricle (DORV) with restrictive subaortic ventricular septal defect (VSD) in which enlargement of the defect at the time of surgical repair was associated with the late postoperative development of a false aneurysm of the left ventricle. The enlarging fale aneurysm caused extrinsic compression of the dominant left circumflex coronary artery, with subsequent ischemia and infarction of the posterolateral left ventricle. The anatomy and surgical implications of restrictive VSD are discussed.