Repair of mitral subvalvular apparatus and a calcified left ventricle aneurysm

Abstract

Left ventricle (LV) myocardial infarction may result in changes to the structure of the subvalvular apparatus. This may lead to a functional regurgitation if accompanied by annular dilatation preventing coaptation of leaflets. Scar tissue formation in the left ventricle may also lead to aneurysm of the left ventricle. This can then calcify, making repair of the leaflet technically challenging. We present a case of a mitral valve repair with concomitant repair of left ventricle aneurysm in a 75-year-old gentleman who suffered an ST-segment elevation myocardial infarction to the lateral wall 20 years ago. He presented with breathlessness on minimal activity, severe mitral regurgitation with a posteriorly oriented regurgitant jet and calcification of LV aneurysm on chest X-ray and computed tomography scan. Despite the challenging nature, it is possible to repair a mitral valve with concomitant calcified LV aneurysm formation. Long term outcomes are still unknown for this cohort of patients.

Keywords

Transmural infarct / left ventricular dilatation / ischaemic mitral valve repair / left ventricular aneurysm with calcification

References

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