Home About us Editorial board Search Ahead of print Current issue Archives Submit article Instructions Subscribe Contacts Login 


 
 Table of Contents  
LETTER TO EDITOR
Year : 2016  |  Volume : 26  |  Issue : 3  |  Page : 106-107

Rare subvalvular left ventricular aneurysm


1 Department of Cardiac Anesthesia, Dharam Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India
2 Department of Cardiac Surgery, Dharam Vira Heart Center, Sir Ganga Ram Hospital, New Delhi, India

Date of Web Publication8-Aug-2016

Correspondence Address:
Dr. Monish S Raut
Department of Cardiac Anesthesia, Dharam Vira Heart Center, Sir Ganga Ram Hospital, New Delhi
India
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2211-4122.187966

Rights and Permissions

How to cite this article:
Raut MS, Maheshwari A, Shad S. Rare subvalvular left ventricular aneurysm. J Cardiovasc Echography 2016;26:106-7

How to cite this URL:
Raut MS, Maheshwari A, Shad S. Rare subvalvular left ventricular aneurysm. J Cardiovasc Echography [serial online] 2016 [cited 2020 Nov 28];26:106-7. Available from: https://www.jcecho.org/text.asp?2016/26/3/106/187966

Dear Sir,

A 35-year-old male was admitted with a history of palpitations and breathlessness for 2 years. Because of pansystolic murmur of mitral insufficiency and a history of shortness of breath, an echocardiogram was performed which revealed sub-mitral aneurysm (SMA) of size 2.4 cm Χ 1.3 cm communicating with the left ventricular (LV) cavity at the level of medial aspect of mitral annulus [Figure 1] and [Figure 2]. The communication of aneurysm to the LV was through a wide neck [Figure 3]. Severe mitral regurgitation was also noted [Figure 4]. Intraoperatively, bulky fibrotic trabeculations were seen adherent to P1/P2/P3 segmental annulus, and aneurysm was below the P3 segment. Sub-mitral fibrotic area was covered with a pericardial patch and mechanical mitral prosthetic valve was inserted [Figure 5].
Figure 1: Transesophageal echocardiography 2 chamber view showing subvalvular aneurysm

Click here to view
Figure 2: Transesophageal echocardiography 4 chamber view showing subvalvular aneurysm

Click here to view
Figure 3: Transesophageal echocardiography 2 chamber transgastric view showing subvalvular aneurysm

Click here to view
Figure 4: Transesophageal echocardiography 2 chamber view showing severe mitral regurgitation

Click here to view
Figure 5: Transesophageal echocardiography 2 chamber transgastric view showing pericardial patch closing subvalvular aneurysm

Click here to view


Subvalvar LV aneurysm is an uncommon, nonischemic LV aneurysm. It is mostly reported in African population with an estimated incidence of 34/10,000 cardiovascular illnesses. [1] SMA is a congenital defect in LV wall resulting in outpouching of the wall near to the posterior mitral leaflet. [2] Posterior mitral leaflet is attached to the myocardium by mitral annular fibrous ring. Defect of this fibro-muscular junction results in subvalvular aneurysm below the posterior leaflet. [3] Such aneurysm causes distortion of annulus and subvalvular apparatus with resultant secondary mitral regurgitation. Subvalvar aneurysm can have potentially dreadful complications such as aneurismal rupture causing cardiac tamponade and aneurismal compression causing coronary artery obstruction and acute myocardial ischemia. [4] Surgical repair of aneurysm is preferred.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Ruiz D, Domingo P, Canals E, Mata J. Annular submitral left ventricular aneurysm. Eur Heart J 1992;13:424-5.  Back to cited text no. 1
    
2.
Antunes MJ. Submitral left ventricular aneurysms. Correction by a new transatrial approach. J Thorac Cardiovasc Surg 1987;94:241-5.  Back to cited text no. 2
[PUBMED]    
3.
Chesler E, Mitha AS, Edwards JE. Congenital aneurysms adjacent to the annuli of the aortic and/or mitral valves. Chest 1982;82:334-7.  Back to cited text no. 3
[PUBMED]    
4.
Cheng TO. Submitral aneurysm is not a false aneurysm. Circulation 1999;100:212-3.  Back to cited text no. 4
[PUBMED]    


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5]


This article has been cited by
1 Submitral congenital left ventricular aneurysm: You recognize only what you know
Giovanni Corrado
Journal of Cardiovascular Echography. 2017; 27(1): 29
[Pubmed] | [DOI]



 

Top
 
 
  Search
 
Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
Access Statistics
Email Alert *
Add to My List *
* Registration required (free)

 
  In this article
References
Article Figures

 Article Access Statistics
    Viewed2123    
    Printed20    
    Emailed0    
    PDF Downloaded71    
    Comments [Add]    
    Cited by others 1    

Recommend this journal


[TAG2]
[TAG3]
[TAG4]