[Successful surgical repair of subepicardial aneurysm developing as a late complication of mitral valve replacement].
A 60-year-old man who undergone uneventful mitral valve replacement 9 years and 5 months previously was referred to us because his chest roentgenogram showed rapidly growing abnormal shadow. Two-dimensional echo cardiography revealed a left ventricular pseudoaneurysm. Emergent surgery was performed under the cardiopulmonary bypass. The aneurysm, which arose posteriorly from the base of the left ventricle, had a thin wall that could be separated from the pericardium. It was therefore diagnosed to be a subepicardial aneurysm. Examination of his previously implanted mitral prosthesis (a Duromedicus valve) revealed that the mitral orifice was partially occluded by a thrombus. The Duromecicus valve was therefore removed, and the ruptured left ventricular wall was closed from both outside and inside. A St. Jude Medical valve was then placed in the mitral position. Pseudoaneurysm or subepicardial aneurysm formation is a possible late complication after mitral valve replacement. Physicians and surgeons should be aware of this late complication in patients who had undergone mitral valve replacement because it urgently requires surgical correction.
Sudo
Y
Y
Division of Cardiovascular Surgery, Funabashi Municipal Medical Center, Chiba, Japan.
Takahara
Y
Y
D002315:Cardiopulmonary Bypass; D004630:Emergencies; D006322:Heart Aneurysm / Q000209:etiology / Q000601:surgery*; D006350:Heart Valve Prosthesis / Q000009:adverse effects*; D006352:Heart Ventricles / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D008943:Mitral Valve / Q000601:surgery; D011183:Postoperative Complications