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 as demonstrated by the presence of lymphoblasts 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 aneurysm through repair of the mitral valve annular disruption. The aneurysm is likely to be due to partially treated endocarditis, weakening the mitral valve atrioventricular junction, resulting in dehiscence. Recovery post-operatively was uneventful and he was able to undergo CAR-T cell therapy several months later.