Successful Surgical Repair of a Congenital Subvalvular Left Ventricular Aneurysm

Abstract

Subannular left ventricular aneurysms are rare in white persons. Six white patients have been reported in the literature who underwent surgical repair because of subaortic left ventricular aneurysm. The authors report on a further case, a 41 year-old woman who was operated on at their clinic. The rare occurrence of this disease inspired them to review the literature and to describe their case.

A Review on the Surgical Management of Subvalvular Aneurysm

“…With respect to drawing conclusions from the literature, we then synthesized all available data in this narrative review to outline the issues of concern, diagnostic clues, and various techniques performed to repair the primary as well as concomitant anomalies. 1 …”

“…5 -7,11,15,16,20 The age of the patients at initial diagnosis and at necropsy ranged from 1 day to 80 years (mean, 29.42 ± 17.2; median 28 years). 3 -44 Male sex predominates by a ratio of 2:1 among black patients. 59 However, both sexes are equally affected among white patients.…”

“…The surgical techniques used in patients with subvalvular aortic aneurysm may be categorized into any of the following nine categories (Tables 1 and 2): Suture obliteration as described by Collins 2 and Vanelli et al 22 Dacron or polytetrafluoroethylene patch closure as practiced by Lavee and other investigators. 19,20,25 -27 Excision of the aneurysmal sac. 38 Replacement of the aortic valve and obliteration of the ostium of the left ventricular subaortic aneurysm.…”

“…37 Aortic valve replacement and plication of the aneurysm. 2,23,25,28,35 Aortic root replacement using a homograft or a composite synthetic conduit. 16,33 In two patients aged 3 years and 41 years with mycotic subaortic aneurysm, some investigators have performed homograft aortic root replacement. Aortic root replacement using a composite synthetic conduit to which Teflon felt flange was attached.…”

“…Dacron or polytetrafluoroethylene patch closure as practiced by Lavee and other investigators. 19,20,25 -27…”