Ventricular aneurysms after cardiac surgery.

were left ventricular aneurysms, all of which occurred after the operation of closed or 'blind' aortic valvotomy in adults, and four were right ventricular outflow tract aneurysms which developed in children after surgical procedures for the correction of severe forms of Fallot's tetralogy. Two of the left ventricular aneurysms arose at the site of the ventriculotomy usedfor introducing the Brock's dilator. The third aneurysm in an adult presented as a surprise finding at a second operation at which the calcified aortic valve was replaced. This aneurysm may have resulted from the creation of a 'false passage' through friable calcification at the base of the aortic leaflet of the mitral valve at the time of closed valvotomy. In the tetralogy cases a significant pressure gradient remained across the right ventricular outflow tract or pulmonary valve ring after operation. It is suggested that this is an important factor in the aetiology of this type of aneurysm.