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September 15, 2026European Heart Journal Supplements

Postischemic Left Ventricular Pseudoaneurysm With Severe Functional Mitral Regurgitation Treated With Minimally Invasive Beating Heart Technique and Geometric Lv Remodeling

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Key result

Minimally invasive beating-heart LV pseudoaneurysm repair eliminates residual MR by modifying ventricular geometry.

  • n=1

Why the study?

Chronic mechanical complications of myocardial infarction such as postischemic LV pseudoaneurysm with severe functional mitral regurgitation require tailored high-risk interventions to minimize procedural risks.

Population

A 66-year-old female with postischemic LV pseudoaneurysm, severe functional MR, and reduced LVEF

Comparison

Minimally invasive beating heart technique with geometric LV remodeling

Design

Case report

Follow-up

1 week until discharge

Authors

ANA NennaUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro”CDC DominiciUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro”SMS ManganielloUniversità degli Studi del Piemonte Orientale “Amedeo Avogadro”

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Overview

Incidental post-MI LV pseudoaneurysm with severe MR and low LVEF warrants vigilance in follow-up; leaves open optimal management strategies.

Key Points

  • To describe a minimally invasive, beating-heart surgical technique for repairing a postischemic left ventricular pseudoaneurysm accompanied by severe functional mitral regurgitation.
  • Evaluated a 66-year-old female presenting with a 2 cm inferoposterior left ventricular breach, a 5 cm pericardial pseudoaneurysm, 35% LVEF, and severe functional mitral regurgitation.
  • Conducted surgical repair via a right fourth-intercostal mini-thoracotomy on femoro-femoral cardiopulmonary bypass without aortic cross-clamping using circumferential sutures and pledget-reinforced U-stitches.
  • Surgical reconstruction achieved geometric remodeling and relocated the papillary muscles, completely eliminating residual mitral regurgitation by restoring leaflet coaptation.
  • The patient experienced an uneventful postoperative recovery, was successfully extubated on postoperative day 1, and was discharged to a rehabilitation facility one week later.

Study Design

Type

Case Report (n=1)

Structured PICO

P
Population
A 66-year-old female with a history of myocardial infarction and VSD presenting with a large postischemic left ventricular pseudoaneurysm and severe functional mitral regurgitation.
I
Intervention
Minimally invasive beating heart technique via right mini-thoracotomy and femoro-femoral cardiopulmonary bypass, with pseudoaneurysm repair using circumferential Prolene suture and interrupted Prolene U-stitches reinforced with pledgets to achieve geometric LV remodeling.
O
Outcome
Successful repair of pseudoaneurysm and elimination of residual mitral regurgitation.

A minimally invasive beating heart technique successfully treated a complex postischemic LV pseudoaneurysm and severe functional mitral regurgitation by modifying ventricular geometry.

Cite This Study

Nenna et al. (2026) conducted a case report in Postischemic left ventricular pseudoaneurysm with severe functional mitral regurgitation (n=1). Minimally invasive beating heart technique and geometric LV remodeling was evaluated on Postoperative residual mitral regurgitation and patient recovery. Minimally invasive beating heart repair of a postischemic left ventricular pseudoaneurysm successfully eliminated residual mitral regurgitation by modifying ventricular geometry.

synapsesocial.com/papers/6aa9016aeed42882c1fc184ehttps://doi.org/10.1093/eurheartjsupp/suag058.153
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Surgical Treatment of a Giant Postero-Inferior Left Ventricular Pseudoaneurysm Causing Severe Mitral Insufficiency and Congestive Heart Failure2011 · 10 citations
  2. 2Successful Resection of a Giant Left Ventricular Pseudoaneurysm Developed Later after Mitral Valve Replacement2010 · 9 citations
  3. 3Large submitral left ventricular pseudoaneurysm following inferior wall ST-elevation myocardial infarction successfully managed with isolated Dor endoventricular circular patch plasty: a case report2026
  4. 4Repairing the mitral valve without touching the mitral valve—a novel technique2024 · 1 citations
  5. 5Surgical Treatment of Left Ventricular Pseudoaneurysm2018 · 9 citations