Acquired Submitral Aneurysm in an Adolescent with Relapse of B-cell Acute Lymphoblastic Leukemia and History of Multiple Systemic Infections: A Case Report

We present the case of a 14-year-old boy with history of B-cell acute lymphoblastic leukemia (ALL), multiple polymicrobial infections, and recent pericardial effusion requiring pericardiocentesis who was incidentally found to have a submitral left ventricular aneurysm. Concurrently, he developed a relapse of his B-cell ALL in his cerebrospinal fluid. The decision was made to proceed with surgical repair of the aneurysm prior to initiation of systemic chemotherapy. The patient underwent a successful repair of the mitral valve annular disruption that caused the aneurysm to form. We suspect that the aneurysm occurred due to partially treated endocarditis that weakened the mitral valve annulus and led to dehiscence. His recovery post-operatively was uncomplicated and he was able to undergo CAR-T cell therapy several months later.