Submitral aneurysm is a rare differential diagnosis in the evaluation of mitral regurgitation. The location of submitral aneurysm beneath the mitral annulus leads to distortion of the posterior mitral leaflet which is the cause for mitral regurgitation. Surgical exclusion of submitral aneurysm and sometimes repair of posterior mitral leaflet or replacement of mitral valve is necessary in managing these patients. We report this case due to the rare presentation of submitral aneurysm in a bicuspid aortic valve disease with ascending aortic aneurysm and post Bentall’s status causing severe stretching and deformation of the posterior mitral leaflet which resembled a cystic mass in the left atrial cavity.
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