Internal repair of left ventricular pseudoaneurysm late after mitral valve replacement

Late left ventricular pseudoaneurysm is a rare complication after mitral valve replacement. Most investigators have recommended surgical repair to treat left ventricular pseudoaneurysm, since untreated left ventricular pseudoaneurysm have a high risk of rupture. Here, we report a case of a 57-year old man with left ventricular pseudoaneurysm. He had two prior mitral valve replacements 16 and 19 years ago, as well as mitral and aortic valve endocarditis causing mitral valve perivalvular leak and perforation of the aortic valve. The mitral and aortic valves were replaced with bovine pericardial valves. Left ventricular pseudoaneurysm was successfully repaired internally in our case because the internal wall at the level of the left ventricle was very fibrotic and matured.