Late-phase left ventricular pseudoaneurysm after three-time mitral valve surgery

Rupture of the left ventricular posterior wall is a fatal complication during mitral valve replacement (MVR), and rupture mainly occurs intraoperatively and up to several days after MVR, but it rarely occurs in the late phase, such as several years postoperatively. Late rupture occasionally presents as left ventricular pseudoaneurysms (LVPAs). A 40-year-old man who had a three-time history of mitral valve surgery for infectious endocarditis was incidentally found to have a left ventricular aneurysm with no symptoms. He underwent closure of a LVPA with MVR. Although there are various surgical techniques to close LVPAs after mitral valve repair, it is still a challenging problem. Here, we report the case of a patient who successfully underwent LVPA repair with MVR and describe the technique.