INTRODUCTION
Submitral left ventricular aneurysms are widely recognized but mainly described in Sub Saharan Africa. These aneurysms occur in relation to the annulus of the mitral valve around the posteromedial commissural line. Patients may be asymptomatic or present with symptoms due to valvar regurgitation or from compression of cardiac structures. The aetiology is usually congenital although co existent pathology such as rheumatic carditis or tuberculosis has been described.

METHODS
This retrospective review describes the clinical, anatomical and histological features of submitral aneurysms seen in the paediatric population at a South African academic hospital complex between 2001 and 2007.

RESULTS
There were six patients, aged 13 months to 15 years. Five of the patients presented with mitral regurgitation and congestive cardiac failure. The diagnosis was made in all instances on transthoracic echocardiography and supplemented with transoesophageal echocardiography or angiograms selectively. Five of the six patients underwent surgery and in 4 of these patients the aneurysm was related to the posterior mitral leaflet and in one patient the aneurysm was related to the anterior mitral leaflet. Histological diagnosis revealed features of rheumatic carditis in 2 patients, features of tuberculosis in one patient and nonspecific features in 2 patients. The outcome in all patients who underwent surgery was favourable. The sixth patient died soon after the initial diagnosis.

CONCLUSION
Submitral aneurysms are not uncommon. Surgery is the treatment of choice and ususlly has a good outcome.