Journal of Cardio-Thoracic Medicine

Journal of Cardio-Thoracic Medicine

Submitral Left Ventricular Aneurysms: Correction through a Transmitral Approach

Document Type : Case Report

Authors
Chirag Doshi
Sumit Modi
Aakash Dinesh Joshi
Ibrahim Mohammed
Mausam Garachh
Opjinder Deepak
Departments of Cardiothoracic and Vascular Surgery, UN Mehta Institute of Cardiology and Research, India.
10.22038/jctm.2024.77005.1441
Abstract
Introduction: Submitral aneurysms (SMA) are a rare heart condition that is more common among young Africans. The etiology is primarily congenital, but when SMA is found in patients of other races, other etiologies must be sought, especially ischemic. The other suggested aetiologies are infection and inflammation. Patients with submitral aneurysms can present with a variety of clinical manifestations.
Case presentation: We present the case of a 57-year-old male patient who was asymptomatic and admitted for evaluation. Transthoracic echocardiography revealed a submitral aneurysm.
Clinical discussion: Submitral left ventricular aneurysm is a rare cardiac pathology with various of causes including inflammation, infection, traumatic illness, or, in rare instances, ischemic heart disease. It can result from a congenital defect in the posterior portion of the mitral annulus, which is more prevalent in the African population. Clinical manifestations can be severe, such as ventricular tachycardia, cardiogenic shock or an embolic phenomenon. However, asymptomatic cases are possible but uncommon.
Conclusion: Our case highlights that SMA can be either the cause or result of coronary ischemia, emphasizing the importance of vigilance in patients with atypical clinical presentations.
Keywords
Aneurysm
Left ventricle
Submitral
Thrombus Arrhythmia
Pericardial effusion
Case report
  1.  ABRAHAMS GD, Barton CJ, COCKSHOTT PW, Edington GM, Weaver EJ. Annular subvalvular left ventricular aneurysms. QJM: An International Journal of Medicine. 1962 Jul 1;31(3):345-60.
  2. Ruiz D, Domingo P, Canals E, Mata J. Annular submitral left ventricular aneurysm. European heart journal. 1992 Mar 1;13(3):424-5.
  3. Ribeiro PJ, Mendes RG, Vicente WV, Menardi AC, Evora PR. Submitral left ventricular aneurysm. Case report and review of published Brazilian cases. Arquivos brasileiros de cardiologia. 2001;76:399-402.
  4. Luo WZ, Ni YM. Submitral left ventricular aneurysm: a rare disease in xanthoderm. Annals of Thoracic and Cardiovascular Surgery. 2014;20(Supplement):909-10.
  5. Du Toit HJ, Von Oppell UO, Hewitson J, Lawrenson J, Davies J. Left ventricular sub-valvar mitral aneurysms. Interactive Cardiovascular and Thoracic Surgery. 2003 Dec 1;2(4):547-51.

 

Journal of Cardio-Thoracic Medicine
Volume 13, Issue 1
Winter 2025
Pages 1494-1499