A 6-year-old girl with a subaortic membrane underwent membrane resection with myomectomy. Two months later, she presented with multiple episodes of exertional syncope, with repolarization anomalies on anterior electrocardiogram leads and negative cardiac biomarkers. Exercise testing was non-conclusive. Echocardiography and computed tomography scan of the chest showed a large left ventricular pseudoaneurysm ( Fig. 1 ). Simultaneous coronarography and ventriculography showed displacement of the left coronary artery, with dynamic disappearance of the coronary flow ( Fig. 2 A ) by the left ventricular pseudoaneurysm ( Fig. 2 ; Video 1 ). Surgery ratified the catheterization findings, showing a large left ventricular pseudoaneurysm at the site of myomectomy, posterior to the pulmonary trunk and compressing the left main coronary artery. Postoperative transthoracic echocardiography showed mild septal dyskinesia. Repeat coronarography showed mild systolic compression of the first segment of the left coronary artery ( Fig. 3 A ; Video 2 ) and complete disappearance of the aneurysm, with no coronary displacement ( Fig. 3 B). Six months later, the patient remains asymptomatic, with no repolarization anomalies on ergometry and normalization of the septal movement on echocardiography.
