Subaortic aneurysm in infective endocarditis

A Review on the Surgical Management of Subvalvular Aneurysm

The present perspective is a synthesis of published investigations in the setting of subvalvular aortic aneurysms. We identified 75 investigations and reviewed the clinical presentation, diagnostic modalities used, surgical techniques employed, and their outcomes. Clinical presentation, radiographic findings, transthoracic and transesophageal echocardiography, electrocardiogram-gated computerized tomography, and magnetic resonance imaging provided the diagnostic information and were used to define the disease entity before surgery. In this article, we have attempted to address several issues concerning establishment of diagnosis, varied clinical presentation, and their management. We submit that an increased appreciation of this disease entity will contribute to improved surgical management.

Coexistence of a huge subaortic left ventricular aneurysm and a saccular descending aortic aneurysm

A huge subaortic left ventricular aneursym was diagnosed in an asymptomatic 22-year-old male patient. The walls of aneurysm were calcific and compressed the left atrium. Also, a saccular descending aortic aneursym and moderate mitral insufficiency associated with subaortic left ventricular aneurysm were found in the current case. Up to now, the coexistence of congenital left ventricular aneurysm and saccular aortic aneursym has not been reported in the literature. We present the first case of congenital left ventricular aneurysm combined with saccular aortic aneurysm in descending thoracic aorta in this case report.

Calcified subaortic left ventricular aneurysm causing right pulmonary artery obstruction in a child

A 14-year old asymptomatic boy was diagnosed as having a large calcified subaortic left ventricular aneurysm that was found to obstruct flow across the right pulmonary artery during systole. Surgical patch closure of the neck of the aneurysm resulted in relief of obstruction. The case is reported for its rarity, massive calcification, absence of aortic regurgitation and dynamic compression of the right pulmonary artery.

Cardiac pseudoaneurysm caused by mitral ring calcification

A case of left ventricular pseudoaneurysm caused by mitral ring calcification (MRC) in a 71-year-old woman is reported. MRC was initially detected by two-dimensional echocardiography. Two months later, rupture of the posterior wall and pseudoaneurysm formation were diagnosed. Mitral value replacement and reconstructive surgery of the myocardial wall were performed. The patient died 46 days after the operation. At autopsy, there was no histopathological evidence of myocardial infarction, infective endocarditis, or other conditions affecting the cardiac endomyocardium. Pseudoaneurysm apparently resulted from left atrial and ventricular tears caused by MRC.