Left ventricular pseudoaneurysm arising between two papillary muscles: repair without mitral regurgitation.

Left ventricular pseudoaneurysm is a rare lesion that occurs when a contained free-wall rupture occurs after a transmural myocardial infarction. Such a pseudoaneurysm may be lethal if subsequent rupture or progressive heart failure occurs. We describe a 67-year-old man who, one year after undergoing coronary artery bypass grafting, developed an infero-apical left ventricular pseudoaneurysm between the bases of two papillary muscles without incurring significant mitral regurgitation. This was a highly unusual presentation. We were able to repair the aneurysm and restore normal mitral geometry without causing regurgitation.