Submitral aneurysm correction with mitral valve repair: a case report.

Submitral aneurysm is a rare type of non-ischaemic ventricular aneurysm. We describe the case of a 26-year-old woman with progressive dyspnoea for approximately 1 year who was diagnosed with a ruptured submitral aneurysm in the left atrium with severe regurgitation. The patient underwent aneurysm correction and mitral valve repair, and post-operative echocardiography showed no residual abnormalities. The patient remains asymptomatic.

Rare association of aneurysm of anterior mitral leaflet with bicuspid aortic valve.

Mitral valve aneurysm is defined as outpouching of the mitral valve which expands in systole and collapse in diastole. It was first reported in 1729 by Morand. Most of the cases have been described in the African population. It is rare in the Indian population. Its chief presentations are congestive heart failure, palpitations, arrhythmia, or in rare cases an embolic phenomenon. It can be diagnosed either by echocardiography or cardiac imaging (magnetic resonance imaging/computed tomography). It can either occur as an isolated defect or with other associated valvular abnormalities. Here, we present a case of a 40-year-old male who was referred for the evaluation of palpitation who on the investigation was found to have a bicuspid aortic valve with severe Aortic Regurgitation (AR) along with aneurysm in the anterior mitral leaflet causing severe mitral regurgitation. This case highlights the importance of keeping a submitral aneurysm as a differential diagnosis for mitral regurgitation and searching for other associated valvular defects which may affect the management and treatment outcomes.

Résumé L'anévrisme de la valve mitrale est défini comme un gonflement de la valve mitrale qui se dilate en systole et s'effondre en diastole. Il a été signalé pour la première fois en. 1729 par Morand. La plupart des cas ont été décrits dans la population africaine. Il est rare dans la population indienne. Ses principales présentations sont insuffisance cardiaque congestive, palpitations, arythmie, ou dans de rares cas un phénomène embolique. Elle peut être diagnostiquée soit par échocardiographie, soit imagerie cardiaque (imagerie par résonance magnétique/tomodensitométrie). Il peut se produire soit comme un défaut isolé, soit avec d'autres défauts valvulaires associés. anomalies. Nous présentons ici le cas d'un homme de 40 ans qui a été référé pour l'évaluation de palpitations et qui, à l'examen, a été s'est avéré avoir une valve aortique bicuspide avec une insuffisance aortique sévère ainsi qu'un anévrisme dans le feuillet mitral antérieur provoquant une insuffisance mitrale sévère. Ce cas met en évidence l'importance de garder un anévrysme subsectoriel comme diagnostic différentiel d'une insuffisance mitrale et de rechercher d'autres défauts valvulaires associés pouvant affecter la prise en charge et les résultats du traitement. Mots-clés: Insuffisance aortique, valve aortique bicuspide, insuffisance mitrale, anévrisme submitral.

Outcome of submitral aneurysm.

INTRODUCTION: Submitral aneurysm is a rare cardiac entity with outpouching in relation to the posterior annulus of the mitral valve. Multiple etiology have been described with the role of infection and inflammation with varied clinical presentation in different case reports. However, the literature on clinical outcome and follow-up is lacking. MATERIAL AND METHOD: This retrospective, observational study included all the adult patients (>18 years) who were diagnosed with a submitral aneurysm. Epidemiological, demographic, laboratory, clinical management, and outcome data were extracted and followed for the endpoints of cardiac death, noncardiac death, recurrent hospitalization (due to heart failure, rupture, arrhythmic events, embolic events), surgical repair, and echocardiography parameters for mitral regurgitation or change in the size of the left ventricle for 1-year postdischarge from the index hospitalization. RESULTS: A total of 10 patients were enrolled in the study with a mean age of 31.2 ± 11.1 years. Possible etiology could be established in only five (50%) patients (two patients had tuberculosis and three patients had acute coronary syndrome). At index hospitalization, nine (90%) patients had heart failure, two (20%) patients had rupture of a submitral aneurysm, four patients underwent surgery, and one patient expired. On follow-up of 1 year, one more patient underwent surgical repair while three patients expired. CONCLUSION: A submitral aneurysm is a rare cardiac entity with poor outcomes. Surgical repair with or without mitral valve replacement plays a definitive role in management.

Submitral aneurysm communicating with coronary sinus in a child.

A newborn girl was referred for a suspected abnormal pulmonary venous return in coronary sinus. Echocardiogram revealed a large outpouching of the left ventricle creating an accessory cardiac chamber that was connected to the left ventricle behind the mural leaflet of the mitral valve, and with the right atrium via the coronary sinus. Ten years later, the orifice between the submitral aneurysm and the left ventricle was closed percutaneously.

Endoventricular Pericardial Patch Repair of a Giant Left Posterior Ventricular Aneurysm.

BACKGROUND/AIM: Left ventricular aneurysms are complications following acute myocardial infarction. Left posterior left ventricular aneurysms occurring in a submitral position constitute a minor entity, and those leaving the mitral apparatus intact are extremely rare. CASE REPORT: Herein, we report the case of a 58-year-old patient with a past medical history of coronary artery disease and myocardial infarction with a giant left posterior left ventricular aneurysm with moderate mitral valve incompetence. RESULTS: The patient underwent myocardial revascularization and, through a transaneurysmal approach, successful endoventricular pericardial patch wall reconstruction with no impact on mitral valve competence. CONCLUSION: Whenever the mitral valve is not affected, a trans aneurysmal approach with endoventricular pericardial patch in association with myocardial revascularization represents a safe and reproducible approach with good functional outcomes.

Transaneurysmal Repair of a Giant Calcified Submitral Left Ventricular Aneurysm.

Submitral left ventricular aneurysm is a rare cardiac pathology with very few cases reported in the literature. These are nonischemic aneurysms mostly reported from Africa. Patients with submitral aneurysm exhibit varied clinical manifestations. We report a case of calcified submitral aneurysm and its successful surgical management through a transaneurysmal approach.

3D printing guided closure of submitral aneurysm-an interesting case.

Submitral aneurysm is a congenital outpouching of the left ventricular wall invariably occurring adjacent to the posterior leaflet of the mitral valve. It usually presents with heart failure symptoms. We report a case of a 59-year-old gentleman with a posterolateral submitral aneurysm who underwent aneurysm patch repair and mitral valve repair. Good knowledge about the interrelationship between the aneurysmal sac and mitral valve was obtained enabling proper surgical repair.

Transaneurysmal R=repair of a giant calcified submitral left ventricular aneurysm

Abstract Submitral left ventricular aneurysm is a rare cardiac pathology with very few cases reported in the literature. These are nonischemic aneurysms mostly reported from Africa. Patients with submitral aneurysm exhibit varied clinical manifestations. We report a case of calcified submitral aneurysm and its successful surgical management through a transaneurysmal approach.

Submitral Left Ventricular Aneurysm Associated with Thrombus.

BACKGROUND: Submitral left ventricular aneurysm is a rarely reported cardiac abnormality that is encountered commonly among blacks. So far, only one case has been reported from Ethiopia and East Africa.Our aim is to report an interesting and rare case that we encountered at St. Paul's Hospital Millennium Medical College. METHODS: In April 2017, a 25-year-old patient havingsubmitral left ventricular aneurysm with New York Heart Association (NYHA) class IV heart failure and mild left ventricular systolic dysfunctionreceived medical treatment at our institution. She had severe mitral regurgitation and aneurysmal thrombus. The diagnosis was easily made using GE Vivid E9 transthoracic echocardiography. She was given drugs for management of heart failure and anticoagulation. RESULTS: Our patient was discharged with a stable condition, and she had no early mortality. At 3 months' follow-up,shehad clinical improvement with NYHA class II heart failure, slight improvement of left ventricular systolic function, and resolution of the left ventricular thrombus. However, there waspersistent severe mitral regurgitation and aneurysm. CONCLUSION: Submitral left ventricular aneurysm is a rare cardiac abnormality. Diagnosis can be easily made with echocardiography. Surgery is the definitive treatment. However, it is not currently available in the country and patients cannot afford treatment abroad.

Submitral Aneurysm After Pulmonary Artery Banding-A Case Report.

Submitral aneurysms are rare clinical entities occurring predominantly in young adults of African descent. A host of etiologies have been proposed for this entity. We present a unique case of submitral aneurysm which developed after pulmonary artery banding in a three-year-old girl with complex congenital heart disease. The aneurysmal sac was burrowing into the interatrial septum.

Ruptured submitral aneurysm.

Submitral aneurysm is a rare entity, with around few hundred cases reported till date. Presentation can be varied. We describe here a case of submitral aneurysm in a young male with rupture into the left atrium cavity.

Submitral aneurysm in children: A rare entity with varied presentation!

We present echocardiographic images in two children with a diagnosis of submitral aneurysm. Both had absolutely different presentations. The diagnosis was established on echocardiography and no advanced imaging techniques were used.

Submitral aneurysm and the new imaging modalities: Will magnetic resonance imaging be necessary?

Submitral aneurysm is a rare cardiac malformation commonly reported in young adult African ancestry. Transthoracic echocardiogram is a gold standard test for diagnosis. Magnetic resonance imaging provides detailed anatomic and functional information of the heart. We present a case of a large bilobed submitral aneurysm in-witch the magnetic resonance imaging confirmed the same findings of the transthoracic echocardiography and in addiction also showed a parietal thrombus.

Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State.

Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures.

Stormy Course of a Huge Submitral Aneurysm Causing Low Cardiac Output State

Submitral aneurysm is a rare structural abnormality of congenital or acquired aetiology. Most reported cases are from Africa. Unless promptly treated surgically this condition is invariably fatal. We report a case of a young Indian male who presented with dyspnea of recent onset, diagnosed to have a massive submitral aneurysm causing low cardiac output and compression of cardiac structures.

Subvalvar Mitral Aneurysm: A Rare Cause of Mitral Leak.

Submitral aneurysm (SMA) results from outpouching of the left ventricular wall which is congenital and occurs adjacent to the posterior leaflet of the mitral valve. Although it is predominantly described among the natives of Africa, it is considered rare in the Indian subcontinent. It presents clinically as palpitation, congestive cardiac failure in the presence of mitral regurgitation, arrhythmias and embolic phenomenon. Echocardiography is the precise diagnostic tool. We report this case of a 24-year-old man who was referred for evaluation of palpitation. This underlines the importance of considering SMA in the differential diagnosis of mitral regurgitation in young patients in our subcontinent where rheumatic etiology usually predominates.