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BackgroundMitral valve aneurysm (MVA) is a saccular outpouching of the mitral leaflet which expands on systole and collapses during diastole. The case of MVA was first described in 1729 by Morand. It is one of the rare entities with a reported incidence of only 0.2–0.29% and no such case reported in Pakistan before.Case presentationA 51 year old female presented with dyspnea and chest pain for 3 months. Upon investigating, trans-esophageal echocardiography (TEE) revealed thickened anterior mitral valve leaflet with rolled up margins, forming an aneurysm, with severe mitral regurgitation. Subsequently, the valve was evaluated intra-operatively for repair but eventually had to be excised and then successfully replaced with a bioprosthetic valve.ConclusionsTEE is an excellent technique to confirm the diagnosis of a mitral valve leaflet aneurysm, and depending upon the severity of the defect, valve repair can be attempted but replacement becomes the most suitable treatment modality, once repair is deemed impossible. We hereby report a rare case, where timely diagnosis, appropriate surgical intervention and regular post-operative follow up helped in achieving good prognosis of this rare entity.

QOL improved from prior to and 1 month after CABG while differing (in specific domains) with respect to age, gender and cardiac rehabilitation programme attendance. The findings can be used to develop interventions to improve health and QOL in specific domains with respect to specific groups.

BackgroundOutcomes following Coronary artery bypass grafting (GABG) vary between genders, with females having a higher postoperative mortality than males. Most of the studies are on Caucasian or mixed population and it is postulated that Asian population and in particular women have higher morbidity and mortality. In this study we have compared outcomes of elective CABG in men and women of South Asian origin in terms of morbidity and mortality.MethodsFrom January 2006 to December 2012, 1970 patients underwent isolated elective CABG at the Aga Khan University Hospital, Pakistan were selected. The prospectively collected data was analyzed retrospectively including univariate and multivariate analysis to find the association of morbidity and mortality.ResultsAmong the study patients 1664 (85%) were male and 306 (15%) female. Hypertension and diabetes were the most common comorbid conditions seen preoperatively in female patients. Atrial fibrillation and sepsis were the most common postop complications seen in females. In hospital mortality was 3.9% in female underwent CABG as against 0.6% in male. Multivariate analysis showed older age, renal failure, dyslipidemia and prolonged cross clamp time as predictors of postoperative morbidity. Multivariate analysis showed female gender, age and renal failure as predictors of in hospital mortality.ConclusionsFemale gender is an independent risk factor for postoperative mortality following CABG however, female gender is not found to be independent risk factor for morbidity. The trend of higher mortality in female patients was comparable to most studies done on Caucasian patients.