1
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Forcillo J, Robert‐Halabi M, Soulez G, Potvin J. Transcatheter occlusion of a left ventricular outflow tract pseudoaneurysm using a “plug and coil” strategy. J Card Surg 2022; 37:3892-3895. [DOI: 10.1111/jocs.16963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 09/01/2022] [Accepted: 09/06/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Jessica Forcillo
- Division of Cardiology and Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM) Montreal Quebec Canada
| | - Maxime Robert‐Halabi
- Division of Cardiology and Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM) Montreal Quebec Canada
| | - Gilles Soulez
- Division of Radiology, Centre Hospitalier de l'Université de Montréal (CHUM) Montreal Quebec Canada
| | - Jeannot Potvin
- Division of Cardiology and Cardiac Surgery, Centre Hospitalier de l'Université de Montréal (CHUM) Montreal Quebec Canada
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2
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Moosavi J, Ahmadi S, Firouzi A, Sadeghipour P, Mohebbi B, Shafe O, Alizadeasl A, Asadian S, Hoseini M. Cardiac solution for a vascular scenario! CVIR Endovasc 2022; 5:9. [PMID: 35103878 PMCID: PMC8807733 DOI: 10.1186/s42155-021-00280-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 12/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ascending aortic pseudoaneurysms (AAPs) constitute a rare, albeit potentially dangerous, condition that occurs in up to 13% of patients after cardiac or aortic surgeries. For patients with a history of cardiac surgery, repeat thoracotomy poses additive risks. The high morbidity and mortality rates associated with the surgical management of AAPs have led to the development of transcatheter approaches. CASE REPORT We report a case of AAP percutaneous closure at the site of aortic cannulation with an ASO device in a post-CABG 65-year-old man, who refused surgery. CONCLUSION The use of the Amplatzer Atrial Septal Defect Occluder (ASO) device represents an acceptable alternative to surgery in treatment of Ascending aortic pseudoaneurysms.
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Affiliation(s)
- Jamal Moosavi
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Somaye Ahmadi
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Ata Firouzi
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Parham Sadeghipour
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Bahram Mohebbi
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Omid Shafe
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Azin Alizadeasl
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sanaz Asadian
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Hoseini
- Rajaei Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
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3
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Minimally Invasive Device Repair of Ascending Aortic Pathology in Selected High-Risk Patients. Ann Surg 2021; 276:e61-e63. [PMID: 34913888 DOI: 10.1097/sla.0000000000005333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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4
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McClure GR, Ratnayake G, Chan A, Gagnon J. Percutaneous closure of a post-surgical ascending aortic pseudoaneurysm with an amplatzer septal occluder device and steerable guiding sheath. Catheter Cardiovasc Interv 2021; 98:E985-E989. [PMID: 34586756 DOI: 10.1002/ccd.29951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 08/30/2021] [Accepted: 09/01/2021] [Indexed: 11/07/2022]
Abstract
Thoracic pseudoaneurysm in the ascending aorta is an uncommon condition associated with significant risk of morbidity and mortality. Treatment is recommended in all cases regardless of symptoms as the mortality rate if left untreated has been documented to be as high as 61%. The current standard of care for managing these lesions is open surgical repair. However, this is associated with significant morbidity. In-hospital mortality reported for patients undergoing surgical repair of an ascending aortic pseudoaneurysm ranges from 6.7% to 41%. When anatomically suitable, a less invasive approach using amplatzer vascular plug or septal occluder is an attractive approach. We present a case report of repair of a post-surgical ascending aortic false aneurysm using an amplatzer septal occluder with an Oscor ™ steerable guiding sheath; a novel approach to increase platform stability when engaging an aneurysm neck. Endovascular occluder deployment for closure of aortic false aneurysms remains a relatively novel technique. It is limited by the requirement to develop a stable endovascular platform to deliver the device and avoid system prolapse, particularly when accessing challenging lesions on the inner aortic curvature. We present the first case to utilize a steerable guiding sheath system to improve system stability and facilitate successful device delivery. Given the significant morbidity associated with open repair of these lesions we hope this will further expand the range of lesions viewed as appropriate for endovascular repair.
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Affiliation(s)
- Graham R McClure
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada.,Population Health Research Institute, McMaster University, Hamilton Health Sciences, Hamilton, Ontario, Canada
| | - Geemitha Ratnayake
- Michael G Degroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Albert Chan
- Department of Medicine, University of British Columbia, New Westminster, British Columbia, Canada.,Division of Interventional Cardiology, Royal Columbian Hospital, New Westminster, British Columbia, Canada
| | - Joel Gagnon
- Department of Surgery, University of British Columbia, New Westminster, British Columbia, Canada.,Division of Vascular Surgery, Royal Columbian Hospital, New Westminster, British Columbia, Canada
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5
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Cuman M, Clemente A, Celi S, Santoro G. 3D model-guided transcatheter closure of ascending aorta pseudoaneurysm with the novel Amplatzer Trevisio intravascular delivery system. Catheter Cardiovasc Interv 2021; 99:140-144. [PMID: 34463417 DOI: 10.1002/ccd.29937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 08/07/2021] [Accepted: 08/21/2021] [Indexed: 11/12/2022]
Abstract
Ascending aorta pseudoaneurysm (AAP) is a rare but life-threatening complication of atherosclerosis, endocarditis, chest trauma, transcatheter or cardio-thoracic procedures. Since surgical repair is burdened by high morbidity and mortality, percutaneous closure is nowadays considered a valuable cost-effective therapeutic alternative. Due to unpredictability and complexity of local anatomy, no standardized technique and device are advised. In this setting, 3D printing technology could significantly help in planning trans-catheter approach. This article reports on a 3D printed model-guided percutaneous closure of a huge AAP using an Amplatzer Septal Occluder (Abbott, Plymouth MN) implanted by the recently commercialized Amplatzer Trevisio Intravascular Delivery System.
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Affiliation(s)
- Magdalena Cuman
- Pediatric Cardiology and GUCH Unit, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio", Massa, Italy
| | - Alberto Clemente
- Radiodiagnostic Unit, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio", Massa, Italy
| | - Simona Celi
- Bioengineering Section, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio", Massa, Italy
| | - Giuseppe Santoro
- Pediatric Cardiology and GUCH Unit, Heart Hospital "G. Pasquinucci", National Research Council-Tuscany Foundation "G. Monasterio", Massa, Italy
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6
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Sivakumar K, Sheth R, Kurien VM, Anbarasu M. Tailored approaches for transcatheter closure of postsurgical pseudoaneurysms from the ascending aorta and brachiocephalic artery. J Cardiol Cases 2020; 23:238-241. [PMID: 33995706 DOI: 10.1016/j.jccase.2020.11.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 10/04/2020] [Accepted: 11/06/2020] [Indexed: 11/16/2022] Open
Abstract
Ascending aortic pseudoaneurysms following open-heart surgery are treated by redo surgery or endovascular therapy when surgical risks are high. Extreme variations in their morphology, proximity to coronary and arch branches and vascular access may vary the timing, strategy, device choice, and technique in each patient. Three patients with varying etiology, presentations, and morphology of the pseudoaneurysms underwent successful endovascular exclusion by individually tailored strategies. The approach includes optimal treatment of the underlying infections before the endovascular intervention despite the emergency to treat the condition; choosing appropriate device depending on the proximity to aortic branches, choosing appropriate access depending on the angulation of the entry of pseudoaneurysm to the aortic lumen, and use of adequate imaging for achieving procedural success. <Learning objective: A tailored approach for transcatheter closure of postsurgical ascending aortic pseudoaneurysms should include: 1 Optimal infection control before the intervention. 2 Choosing nitinol occluders in high-flow aneurysms; vascular plugs and coils for residual leaks; and embolic protection for high clot burden. 3 Choice of femoral, brachial, or transapical access is decided based on angulation of the aneurysm with ascending aorta. 4 Meticulous planning of the interventions based on advanced three-dimensional imaging.>.
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Affiliation(s)
- Kothandam Sivakumar
- Department of Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A, Dr JJ Nagar, Mogappair, Chennai 600037, India
| | - Ronak Sheth
- Department of Cardiology, Institute of Cardio Vascular Diseases, Madras Medical Mission, 4A, Dr JJ Nagar, Mogappair, Chennai 600037, India
| | | | - Mohanraj Anbarasu
- Department of Cardiac Surgery, Institute of Cardio Vascular Diseases, Madras Medical Mission, Chennai, India
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7
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Successful Endovascular Repair of an Aortobronchial Fistula due to Takayasu Arteritis. Ann Vasc Surg 2020; 71:533.e7-533.e10. [PMID: 32949744 DOI: 10.1016/j.avsg.2020.08.152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 08/04/2020] [Accepted: 08/27/2020] [Indexed: 11/22/2022]
Abstract
Endovascular approaches to treating a diseased ascending aorta are challenging. We report the use of an endovascular occlusion device for successful closure of a ruptured penetrating atherosclerotic ulcer of an ascending aorta. A 47-year-old female patient with Takayasu arteritis complained of a worsening hemoptysis. She had a history of Bentall procedure for a sinus of Valsalva aneurysm and redo surgery for a ruptured penetrating atherosclerotic ulcer close to the distal anastomosis. She developed methicillin-resistant Staphylococcus aureus (MRSA) mediastinitis after the second procedure and required negative pressure wound therapy. Computed tomographic angiography revealed recurrence of a ruptured penetrating aortic ulcer and an aortobronchial fistula. Because of the high risk of redo sternotomy after MRSA mediastinitis, we used an endovascular occlusion device to achieve successful percutaneous closure. The patient was discharged without any complications. Postoperative computed tomography scans showed that the endovascular device was positioned without migration and that complete thrombosis of the penetrating atherosclerotic ulcer was achieved. This is the first report on endovascular repair of a ruptured penetrating atherosclerotic ulcer of the ascending aorta in Takayasu arteritis.
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8
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Successful endovascular treatment of an ascending aortic pseudoaneurysm using an Amplatzer Vascular Plug II. Gen Thorac Cardiovasc Surg 2020; 69:91-93. [PMID: 32328995 DOI: 10.1007/s11748-020-01367-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/11/2020] [Indexed: 10/24/2022]
Abstract
Pseudoaneurysms are a rare complication of cardiovascular surgery, caused by disruption of the aortic structure (adventitia, media, and intima). Some reports have observed an extremely high mortality rate associated with the open surgical repair of pseudoaneurysms. In elderly or highly frail patients, the use of less invasive procedures is preferable. In this article, we report a case of an octogenarian who had a symptomatic ascending aortic pseudoaneurysm and a history of two sternotomies and present the successful treatment strategy. We treated the patient via an endovascular procedure using an Amplatzer Vascular Plug II (AVP II). After the intervention, the symptoms of the patient resolved. A computed tomography scan performed 1 year after the procedure confirmed the exclusion of the pseudoaneurysm.
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9
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Ryan L, Collins DT, Mukherjee D. A first time repair of pseudoaneurysm of the ascending aorta with a Valiant Navion Evo thoracic endograft®. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2018; 19:31-34. [PMID: 29970329 DOI: 10.1016/j.carrev.2018.06.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 06/11/2018] [Accepted: 06/11/2018] [Indexed: 11/17/2022]
Abstract
We describe the first case of an endovascular repair for a pseudoaneurysm of the ascending aorta using the Valiant Navion EVO® low-profile thoracic endograft from Medtronic™. A successful outcome from a potentially fatal condition in a severely compromised patient was achieved.
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Affiliation(s)
- Liam Ryan
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA
| | - Devon T Collins
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA; Department of Global and Community Health, George Mason University, Fairfax, VA, USA
| | - Dipankar Mukherjee
- Department of Surgery, Inova Fairfax Medical Campus, Falls Church, VA, USA.
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10
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Hibino M, Katada Y, Shibayama K, Obunai K, Watanabe H, Kawano Y, Watanabe S, Tabata M. Recurrent aortic root pseudoaneurysm after transcatheter occlusion-A word of caution. J Card Surg 2018; 33:190-193. [PMID: 29659089 DOI: 10.1111/jocs.13568] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 48-year-old male developed a recurrent aortic-root pseudoaneurysm after surgical repair for acute dissection. Although the initial closure of the pseudoaneurysm was successfully managed by transcatheter endovascular occlusion and coiling utilizing a hybrid transapical and transfemoral approach, the pseudoaneurysm was recanalized after 3 months and a third-time surgical repair was required. The potential risk for recurrence of pseudoaneurysms should be considered when applying endovascular occlusion devices to treat aortic root anatomy.
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Affiliation(s)
- Makoto Hibino
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Yoshiaki Katada
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan.,Department of Radiology, Tokyo Women's Medical University Medical Center East, Arakawa-ku, Tokyo, Japan
| | - Kentaro Shibayama
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Kotaro Obunai
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Hiroyuki Watanabe
- Department of Cardiology, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Yuji Kawano
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Shun Watanabe
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
| | - Minoru Tabata
- Department of Cardiovascular Surgery, Tokyo Bay Urayasu Ichikawa Medical Center, Urayasu-shi, Chiba, Japan
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11
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Fallatah R, Elasfar AA, Alzubaidi S, Alraddadi M, Abuelatta R. Endovascular repair of a leaking aortic-arch pseudoaneurysm using graft stent combined with chimney protection to left common carotid artery: Case report and review of literature. J Saudi Heart Assoc 2017; 30:254-259. [PMID: 29983500 PMCID: PMC6026385 DOI: 10.1016/j.jsha.2017.10.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Accepted: 10/13/2017] [Indexed: 11/17/2022] Open
Abstract
Aortic pseudoaneurysm (PsA) is a rare but serious condition that has high mortality and morbidity rates if untreated. We report a rare case of leaking aortic-arch PsA repaired by thoracic endovascular aortic repair using graft stent with the chimney technique to protect the left common carotid artery. Unlike other cases in the literature, our case was unique, having leaking PsA not related to previous cardiac surgery or aortic dissection. The successful management of this patient using thoracic endovascular aortic repair combined with the chimney technique suggests that this approach may be an attractive therapeutic alternative to treat aortic-arch PsA.
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Affiliation(s)
- Raneem Fallatah
- Madina Cardiac Center, Madina, Saudi Arabia
- King Abdulaziz University, Jeddah, Saudi Arabia
| | - Abdelfatah A. Elasfar
- Madina Cardiac Center, Madina, Saudi Arabia
- Cardiology Department, Tanta University, Egypt
- Corresponding author at: Madina Cardiac Center, Madina, Saudi Arabia.
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12
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Kim HJ, Lee SM, Sung K, Kang IS, Lee JH, Min JJ, Kim E, Park J, Park JH. Transesophageal echocardiographic guidance for percutaneous closure of aortic pseudoaneurysm using a type II Amplatzer vascular plug: a case report. Korean J Anesthesiol 2016; 69:400-5. [PMID: 27482320 PMCID: PMC4967638 DOI: 10.4097/kjae.2016.69.4.400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2015] [Revised: 10/29/2015] [Accepted: 11/02/2015] [Indexed: 11/12/2022] Open
Abstract
Aortic pseudoaneurysm after cardiac surgery is a rare entity, but it is potentially fatal due to its clinical course along with higher morbidity and mortality rates. Instead of open surgical repair, percutaneous procedures have been introduced as other options for managing an aortic pseudoaneurysm. In this case report, we describe transesophageal echocardiography guidance for successful percutaneous closure of an aortic pseudoaneurysm located in the left ventricular outflow tract by using a type II Amplatzer vascular plug in a patient in whom open surgical repair was not recommended.
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Affiliation(s)
- Hyo Jin Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Sangmin Maria Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kiick Sung
- Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - I-Seok Kang
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jong-Hwan Lee
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jeong Jin Min
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eunhee Kim
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jiyeon Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hyoung Park
- Department of Anesthesiology and Pain Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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13
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Lyen SM, Rodrigues JC, Manghat NE, Hamilton MC, Turner M. Endovascular closure of thoracic aortic pseudoaneurysms: A combined device occlusion and coil embolization technique in patients unsuitable for surgery or stenting. Catheter Cardiovasc Interv 2016; 88:1155-1169. [DOI: 10.1002/ccd.26558] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 03/06/2016] [Accepted: 03/21/2016] [Indexed: 11/09/2022]
Affiliation(s)
- Stephen M. Lyen
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust; Upper Maudlin Street Bristol BS2 8HW
| | - Jonathan C.L. Rodrigues
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust; Upper Maudlin Street Bristol BS2 8HW
| | - Nathan E. Manghat
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust; Upper Maudlin Street Bristol BS2 8HW
| | - Mark C.K. Hamilton
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust; Upper Maudlin Street Bristol BS2 8HW
| | - Mark Turner
- Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust; Upper Maudlin Street Bristol BS2 8HW
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14
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Nogueira MA, Fiarresga A, de Sousa L, Galrinho A, Santos N, Nobre I, Laranjeira Á, Cruz Ferreira R. Percutaneous closure of a large ascending aortic pseudoaneurysm. Rev Port Cardiol 2016; 35:119.e1-5. [PMID: 26852307 DOI: 10.1016/j.repc.2015.09.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2015] [Revised: 09/13/2015] [Accepted: 10/16/2015] [Indexed: 11/26/2022] Open
Abstract
Pseudoaneurysm of the ascending aorta is a rare complication, usually after thoracic surgery or trauma. Since surgical repair is associated with very high morbidity and mortality, percutaneous closure has been described as an alternative. In this regard, we present a case in which a symptomatic large pseudoaneurysm of the ascending aorta was treated percutaneously due to the high surgical risk. Despite the technical difficulties, this procedure had a good final result followed by clinical success.
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Affiliation(s)
| | | | - Lídia de Sousa
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
| | - Ana Galrinho
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
| | - Ninel Santos
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
| | - Isabel Nobre
- Department of Radiology, Lusíadas Hospital, Lisbon, Portugal
| | - Álvaro Laranjeira
- Department of Cardiothoracic Surgery, Santa Marta Hospital, Lisbon, Portugal
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15
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Percutaneous closure of a large ascending aortic pseudoaneurysm. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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16
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Engelbert TL, Gupta PK, Matsumura J. Percutaneous thoracic endovascular aortic repair for ascending aortic pseudoaneurysm after prosthetic aortic valve repair. J Vasc Surg Cases 2015; 1:283-286. [PMID: 31724575 PMCID: PMC6849927 DOI: 10.1016/j.jvsc.2015.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 09/15/2015] [Indexed: 11/25/2022] Open
Abstract
Ascending aortic pseudoaneurysms are an uncommon and challenging surgical problem that requires intervention to avoid rupture and hemorrhage. Preceding cardiac procedures often compound the high rate of morbidity and mortality associated with open repair. A case is described of an iatrogenic pseudoaneurysm in a patient with a recently placed prosthetic aortic valve and a clinical course precluding repeat open operative procedure. An endovascular approach was used, with placement of a thoracic aorta endograft with temporary cardiac pacing and a double-curved Lunderquist wire to avoid instrumenting the prosthetic aortic valve. At 9 months of follow-up, the patient returned to his baseline activity status, and at 24 months, had no symptoms or signs of infection, and a computed tomography angiogram demonstrated pseudoaneurysm exclusion with no graft migration.
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Affiliation(s)
- Travis L Engelbert
- Department of Vascular Therapy, Colorado Permanente Medical Group, Kaiser Permanente, Denver, Colo
| | - Prateek K Gupta
- Division of Vascular Surgery, Methodist Healthcare, University of Tennessee Health Science Center, Memphis, Tenn
| | - Jon Matsumura
- Division of Vascular Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisc
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17
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Roussel A, Fabre D, Fadel E, Angel C, Dartevelle P. Hybrid treatment of an aortic pseudoaneurysm arising at the innominate artery junction secondary to superior vena cava stenting. J Vasc Surg Cases 2015; 1:127-129. [PMID: 31724612 PMCID: PMC6849922 DOI: 10.1016/j.jvsc.2015.03.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2014] [Accepted: 03/15/2015] [Indexed: 12/03/2022] Open
Abstract
Pseudoaneurysm of the innominate artery secondary to superior vena cava stenting has never been reported. We report the case of a 42-year-old woman previously treated for a Masaoka stage III thymoma with superior vena cava replacement through median sternotomy followed by adjuvant radiation therapy. Four years later, the patient came back with a large pseudoaneurysm at the junction of the innominate artery and ascending aorta. To avoid resternotomy, endovascular deployment of a stent graft in the ascending aorta with a periscope stenting in the left common carotid artery after axilloaxillary bypass was performed to treat this aortic pseudoaneurysm.
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Affiliation(s)
- Arnaud Roussel
- Reprint requests: Arnaud Roussel, MD, Department of Vascular and Thoracic Surgery and Lung Transplantation, Bichat Hospital, 46 rue Henri Huchard, 75018 Paris, France
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18
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Barik R, Patnaik AN, Kumar RV, Mohapatra RP, Medep V, Nemani L. Surgical exclusion of postsurgical pseudoaneurysm of the ascending aorta. Ann Pediatr Cardiol 2014; 7:135-7. [PMID: 24987261 PMCID: PMC4070204 DOI: 10.4103/0974-2069.132490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Pseudoaneurysm of ascending aorta after cardiac surgery is rare in children. We report a case of successful surgical exclusion of ascending aortic pseudoaneurysm in a 15-year-old boy. The neck of the aneurysm was in close proximity to the right coronary artery (RCA).
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Affiliation(s)
- Ramachandra Barik
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Amar Narayana Patnaik
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Ravintula Venkata Kumar
- Department of Cardiothoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Rudra Prasad Mohapatra
- Department of Cardiothoracic Surgery, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Vikas Medep
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
| | - Lalita Nemani
- Department of Cardiology, Nizam's Institute of Medical Sciences, Hyderabad, Andhra Pradesh, India
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19
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Patel AV, Gupta S, Laffin LJ, Retzer EM, Dill KE, Shah AP. One size does not fit all: case report of two percutaneous closures of aortic pseudoaneurysm and review of the literature. CARDIOVASCULAR REVASCULARIZATION MEDICINE 2014; 15:160-4. [PMID: 24630705 DOI: 10.1016/j.carrev.2014.02.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2013] [Revised: 02/17/2014] [Accepted: 02/20/2014] [Indexed: 11/26/2022]
Abstract
Aortic pseudoaneurysms (PSAs) are common complications following cardiac surgery, and carry significant morbidity and mortality. Surgical management of aortic PSAs is associated with high mortality, however there are emerging reports of transcatheter techniques for closure of aortic PSAs. We present two cases of ascending aorta PSA which developed following cardiac surgery and were treated percutaneously with novel closure devices. We also describe a comprehensive review of the literature of all published cases of ascending aorta PSA which have been closed percutaneously, and report on the success rate and available devices for percutaneous closure.
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Affiliation(s)
- Amit Vipin Patel
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center
| | - Sameer Gupta
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center
| | - Luke Joseph Laffin
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center
| | | | - Karin Evelyn Dill
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center
| | - Atman Prabodh Shah
- Section of Cardiology, Department of Medicine, University of Chicago Medical Center.
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20
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Endovascular Closure of Ascending Aortic Pseudoaneurysm With a Type II Amplatzer Vascular Plug. Vasc Endovascular Surg 2014; 48:329-32. [DOI: 10.1177/1538574414522329] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A 71-year-old man initially presented with an asymptomatic, incidentally detected ascending aortic pseudoaneurysm 25 years following aortic root repair with mechanical aortic valve replacement. This pseudoaneurysm was previously treated with coil embolization but due to coil impaction it reopened 8 years later. Endovascular closure of the pseudoaneurysm was achieved with the off-label use of a type II Amplatzer vascular plug.
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Giant pseudoaneurysm of the ascending aorta after valve replacement. Medical follow-up for 22 months without complication. Herz 2013; 39:279-81. [PMID: 23535830 DOI: 10.1007/s00059-013-3789-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 02/23/2013] [Indexed: 10/27/2022]
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22
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Scantlebury DC, Alli OO, Joyce LD, Rihal CS. Percutaneous device closure of a pseudoaneurysm arising from the junction of the innominate artery and the aorta. J Thorac Cardiovasc Surg 2012; 144:732-4. [DOI: 10.1016/j.jtcvs.2012.03.069] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2012] [Accepted: 03/30/2012] [Indexed: 10/28/2022]
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23
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Bibiloni Lage I, Benussi S, Verzini A, Alfieri O. Amplatzer device migration through the sternum: a rare complication of percutaneous treatment for an aortic pseudoaneurysm solved by 2 length-adjustable bovine pericardium conduits. J Thorac Cardiovasc Surg 2012; 144:e27-8. [PMID: 22698559 DOI: 10.1016/j.jtcvs.2012.05.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Revised: 04/16/2012] [Accepted: 05/15/2012] [Indexed: 11/27/2022]
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