Giant Left Ventricular Aneurysm in a Child After Surgical Repair of Anomalous Left Coronary Artery From the Pulmonary Artery and Subsequent Mitral Valve Replacement

We report a four-year-old female with anomalous left coronary artery from the pulmonary artery who developed a large left ventricular (LV) aneurysm following coronary reimplantation in early infancy and subsequent mitral valve repair and replacement for progressive mitral valve regurgitation. While the patient was asymptomatic, echocardiogram demonstrated an enlarged LV aneurysm, which was confirmed by cardiac computed tomography angiography. Surgical exclusion of the aneurysm with a patch and replacement of the prosthetic mitral valve were performed. The etiology of late development of an LV aneurysm is inconclusive but could be associated with prior ischemic injury and additional local myocardial impairment following the mitral valve replacement. Routine postoperative surveillance is recommended.