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Naguib M, Elsayed M, Khouzam RN, Iskander A. Percutaneous Closure of Post-Infarct Left Ventricular Pseudoaneurysm; A Review of Literature. Curr Probl Cardiol 2023; 48:101743. [PMID: 37084993 DOI: 10.1016/j.cpcardiol.2023.101743] [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: 04/08/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
Left ventricular pseudoaneurysm is a well-known complication of myocardial infarction and open-heart surgery and has recently been described as succeeding transapical transcatheter aortic valve replacement (TAVR). While surgical intervention is the conventional therapeutic approach, transcatheter closure can be considered in patients at high risk for surgical procedures. In this article, we present a post-myocardial infarction pseudoaneurysm for which closure was done via retrograde left ventricular (LV) access using an Amplatzer Septal Occluder, and provide a review of recent literature focusing on indications and outcomes of the different percutaneous techniques and devices.
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Affiliation(s)
- M Naguib
- Bachelor of Medicine and Bachelor of Surgery and Bachelor of Obstetrics, Roayl college of Surgeons in Ireland & North Lincolnshire and Goole NHS Trust Junior doctor.
| | - M Elsayed
- Bachelor of Medicine and Bachelor of Surgery and Bachelor of Obstetrics, Roayl college of Surgeons in Ireland & Southport at Osmskirk district hospital NHS Junior doctor
| | - R N Khouzam
- Consultant Interventional Cardiologist, Methodist Health Care
| | - A Iskander
- Doctor of Medicine, Consultant Interventional Cardiologist, St. Joseph's Hospital Cardiology Associates, St. Joseph's Health Hospital
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2
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Percutaneous closure of left ventricular pseudoaneurysm. Adv Cardiol 2022; 18:101-110. [PMID: 36051826 PMCID: PMC9421521 DOI: 10.5114/aic.2022.118525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 06/02/2022] [Indexed: 11/19/2022]
Abstract
The aim of the present study is to describe the indications, treatment effects, and patient outcomes of percutaneous management of left ventricular pseudoaneurysm (LVPA). The study materials were based on comprehensive literature retrieval since 2004. The mechanisms of LVPA formation can be divided into surgical, percutaneous, and medial disease related. Of the surgical mechanisms, coronary artery bypass grafting prevailed. The formation time was the longest in medical disease-related LVPAs up to 44.4 months. The percutaneous procedures succeeded on the first try in 79 (84.9%) patients, whereas failures were encountered during the percutaneous manoeuvres in 14 (15.1%) patients. Percutaneous closure of LVPA was especially indicated for patients carrying a high surgical risk. The iatrogenic traumas, such as left ventricular venting, should be avoided to prevent this complication. The preliminary cut-off valves of oversize 3.3 mm and oversize ratio 1.6 should be followed for reference for device choice.
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3
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Ikeda N, Stone DM, Kuriakose EM, Frost J, Haw MP, Vettukattil JJ, Taqatqa AS. Left Ventricular Pseudoaneurysm Following Surgical Repair of Ventricular Septal Defect in an Infant. Pediatr Cardiol 2019; 40:1097-1100. [PMID: 31073802 DOI: 10.1007/s00246-019-02119-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 04/28/2019] [Indexed: 10/26/2022]
Abstract
Left ventricular pseudoaneurysm (LV-PSA) is a rare complication following cardiac surgery, let alone in the pediatric population. Other known causes of LV-PSA are trauma, percutaneous cardiac intervention, and infections. This report describes the development of LV-PSA following surgical repair of ventricular septal defect (VSD) and coarctation of aorta (CoA) in an infant.
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Affiliation(s)
- Nobuyuki Ikeda
- Michigan State University/Sparrow Health System, 1215 E Michigan Avenue, Lansing, MI, 48912, USA
| | - David M Stone
- Helen DeVos Children's Hospital, Children's Heart Center, 3960 Patient Care Drive, Suite 113, Lansing, MI, 48911, USA
| | - Emy M Kuriakose
- Congenital Heart Center, Spectrum Health, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA
| | - Jamie Frost
- Advanced Radiology Services, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA
| | - Marcus P Haw
- Congenital Heart Center, Spectrum Health, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA
| | - Joseph J Vettukattil
- Congenital Heart Center, Spectrum Health, Helen DeVos Children's Hospital, 100 Michigan Street NE, Grand Rapids, MI, 49503, USA
| | - Anas S Taqatqa
- Helen DeVos Children's Hospital, Children's Heart Center, 3960 Patient Care Drive, Suite 113, Lansing, MI, 48911, USA.
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4
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Ruptured left ventricular pseudoaneurysm: A complication of power injector assisted ventricular angiography. Res Cardiovasc Med 2017. [DOI: 10.5812/cardiovascmed.34511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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5
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Afonso Nogueira M, Fiarresga A, de Sousa L, Agapito A, Galrinho A, Cruz Ferreira R. Percutaneous closure of a giant left ventricular wall pseudoaneurysm: Anterograde approach with a double snare technique. Rev Port Cardiol 2016; 35:441.e1-4. [PMID: 27402447 DOI: 10.1016/j.repc.2015.11.023] [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: 07/02/2015] [Accepted: 11/21/2015] [Indexed: 11/17/2022] Open
Abstract
Left ventricular pseudoaneurysm is a rare complication of acute myocardial infarction, cardiac surgery, trauma or infection. Since surgical repair is associated with high morbidity and mortality, percutaneous closure has been described as an alternative. In this regard, we present a case in which a symptomatic large left ventricular pseudoaneurysm was treated by percutaneous closure due to the patient's high surgical risk, using a double snare technique. Despite the technical difficulties, this procedure had a good final result followed by clinical success, confirming that this procedure is an effective alternative to surgery in high-risk patients.
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Affiliation(s)
| | | | - Lídia de Sousa
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
| | - Ana Agapito
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
| | - Ana Galrinho
- Department of Cardiology, Santa Marta Hospital, Lisbon, Portugal
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6
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Kim G, Ban GH, Lee HD, Sung SC, Kim H, Choi KH. Percutaneous closure of pseudoaneurysm in the left ventricle in a young child. Pediatr Int 2016; 58:648-51. [PMID: 26952876 DOI: 10.1111/ped.12893] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 11/13/2015] [Accepted: 12/24/2015] [Indexed: 11/28/2022]
Abstract
Pseudoaneurysm in the left ventricular outflow tract is a rare complication occurring after cardiac surgery. We report on the successful percutaneous device closure of a pseudoaneurysm in the left ventricular outflow tract, which developed in a 23-month-old girl after resection of a subaortic ridge. The pseudoaneurysm was closed using an Amplatzer Vascular Plug II.
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Affiliation(s)
- Geena Kim
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
| | - Gil Ho Ban
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
| | - Hyoung Doo Lee
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
| | - Si Chan Sung
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
| | - Hyungtae Kim
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
| | - Kwang Ho Choi
- Heart Center, Pusan National University Children's Hospital, Yangsan, Korea
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7
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Afonso Nogueira M, Fiarresga A, de Sousa L, Agapito A, Galrinho A, Cruz Ferreira R. Percutaneous closure of a giant left ventricular wall pseudoaneurysm: Anterograde approach with a double snare technique. REVISTA PORTUGUESA DE CARDIOLOGIA (ENGLISH EDITION) 2016. [DOI: 10.1016/j.repce.2015.11.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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8
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Kumar R, Sinha A, Lin MJ, Uchino R, Butryn T, O'Mara MS, Nanda S, Shirani J, Stawicki SP. Complications of pericardiocentesis: A clinical synopsis. Int J Crit Illn Inj Sci 2015; 5:206-12. [PMID: 26557491 PMCID: PMC4613420 DOI: 10.4103/2229-5151.165007] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Pericardiocentesis (PC) is both a diagnostic and a potentially life-saving therapeutic procedure. Currently echocardiography-guided pericardiocentesis is considered the standard clinical practice in the treatment of large pericardial effusions and cardiac tamponade. Although considered relatively safe, this invasive procedure may be associated with certain risks and potentially serious complications. This review provides a summary of pericardiocentesis and a focused overview of the potential complications of this procedure.
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Affiliation(s)
- Rajan Kumar
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Archana Sinha
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Maggie J Lin
- Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Reina Uchino
- Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Tracy Butryn
- Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - M Shay O'Mara
- Department of Surgery, OhioHealth Grant Medical Center, Columbus, Ohio, United States
| | - Sudip Nanda
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Jamshid Shirani
- Department of Cardiology, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
| | - Stanislaw P Stawicki
- Department of Surgery, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States ; Research and Innovation, St. Luke's University Health Network, Bethlehem, Pennsylvania, United States
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9
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Feldman T, Pearson P, Smart SS. Percutaneous closure of post TAVR LV apical pseudoaneurysm. Catheter Cardiovasc Interv 2015; 88:479-85. [DOI: 10.1002/ccd.26157] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 07/24/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Ted Feldman
- NorthShore University HealthSystem; Evanston Illinois
| | - Paul Pearson
- NorthShore University HealthSystem; Evanston Illinois
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10
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Zacharoulis A, Antoniades A, Frogoudaki A, Kolokathis F, Lekakis J. TAVR in patients with aortic stenosis and mechanical mitral valve. Int J Cardiol 2015; 180:226-7. [PMID: 25463373 DOI: 10.1016/j.ijcard.2014.11.130] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2014] [Accepted: 11/22/2014] [Indexed: 11/29/2022]
Affiliation(s)
- Achilles Zacharoulis
- Athens University Medical School, 2nd Cardiology Department, Attikon University Hospital, Greece
| | - Aias Antoniades
- Athens University Medical School, 2nd Cardiology Department, Attikon University Hospital, Greece
| | - Alexandra Frogoudaki
- Athens University Medical School, 2nd Cardiology Department, Attikon University Hospital, Greece
| | - Fotios Kolokathis
- Athens University Medical School, 2nd Cardiology Department, Attikon University Hospital, Greece
| | - John Lekakis
- Athens University Medical School, 2nd Cardiology Department, Attikon University Hospital, Greece
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11
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Melman YF, Levy MS, Laham RJ. Intracardiac echocardiography and fluoroscopy guided percutaneous left ventricular pseudoaneurysm closure. Catheter Cardiovasc Interv 2013; 82:E915-8. [DOI: 10.1002/ccd.23321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2011] [Accepted: 07/17/2011] [Indexed: 11/12/2022]
Affiliation(s)
- Yonathan F. Melman
- Cardiology Division; Beth Israel Deaconess Medical Center, Harvard Medical School; Boston Massachusetts
| | - Michael S. Levy
- Cardiology Division; Beth Israel Deaconess Medical Center, Harvard Medical School; Boston Massachusetts
| | - Roger J. Laham
- Cardiology Division; Beth Israel Deaconess Medical Center, Harvard Medical School; Boston Massachusetts
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12
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Hemolytic hyperbilirubinemia after percutaneous device closure of left ventricular pseudoaneurysm: a disregarded complication. Ann Thorac Surg 2013; 95:707-9. [PMID: 23336887 DOI: 10.1016/j.athoracsur.2012.06.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2012] [Revised: 05/13/2012] [Accepted: 06/04/2012] [Indexed: 11/21/2022]
Abstract
Surgical repair of a left ventricular pseudoaneurysm is challenging. Percutaneous closure with an AMPLATZER Septal Occluder (AGA Medical Corporation, Golden Valley, MN) has evolved to be an effective alternative to conventional surgery with less complication. We report a case of severe hemolytic hyperbilirubinemia and acute renal failure after percutaneous left ventricular pseudoaneurysm endoprothesis repair, which required conventional surgical repair through a left thoracotomy to treat this complication. The rationale and results of such an off-the-label usage of AMPLATZER Septal Occluder were reexamined. Residual leakages were not rare findings in the reviewed literature. The indications for this approach should be individualized.
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13
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Cwikiel W, Keussen I, Gustafsson R, Mokhtari A. Endovascular treatment of two pseudoaneurysms originating from the left ventricle. Cardiovasc Intervent Radiol 2013; 36:1677-1680. [PMID: 23334841 PMCID: PMC3825576 DOI: 10.1007/s00270-012-0540-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2012] [Accepted: 10/25/2012] [Indexed: 11/30/2022]
Abstract
A 67-year-old woman resented with an acute type A aortic dissection, which was treated surgically with aortic valve replacement as a composite graft with reimplantation of the coronary arteries. At the end of surgery, a left-ventricular venting catheter was placed through the apex and closed with a buffered suture. Consecutive computed tomography (CT) examinations verified a growing apex pseudoaneurysm. Communication between the ventricle and the pseudoaneurysm was successfully closed with an Amplatz septal plug by the transfemoral route. Follow-up CT showed an additional pseudoaneurysm, which also was successfully closed using the same method.
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Affiliation(s)
- Wojciech Cwikiel
- Department of Radiology, Skane University Hospital, 22185, Lund, Sweden.
| | - Inger Keussen
- Department of Radiology, Skane University Hospital, 22185, Lund, Sweden
| | - Ronny Gustafsson
- Department of Thoracic Surgery, Skane University Hospital, Lund, Sweden
| | - Arash Mokhtari
- Department of Thoracic Surgery, Skane University Hospital, Lund, Sweden
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14
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Narayan RL, Vaishnava P, Goldman ME, Stelzer P, Clark L, Kini AS, Sharma SK, Love B. Percutaneous closure of left ventricular pseudoaneurysm. Ann Thorac Surg 2013; 94:e123-5. [PMID: 23098987 DOI: 10.1016/j.athoracsur.2012.05.086] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2012] [Revised: 04/14/2012] [Accepted: 05/11/2012] [Indexed: 11/30/2022]
Abstract
The risk of rupture of a left ventricular (LV) pseudoaneurysm ranges from 30% to 45% in the first year. Open surgical repair carries high mortality related to anatomic complexity and patient comorbidities. Percutaneous closure may offer a viable alternative to surgical intervention in this cohort. Herein, we describe 3 unique cases of transcatheter LV pseudoaneurysm closure.
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15
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Bortnick AE, Gordon E, Gutsche J, Anwaruddin S, Szeto WY, Desai N, Vallabhajosyula P, Bavaria JE, Herrmann HC. Percutaneous Closure of a Left Ventricular Pseudoaneurysm After Sapien XT Transapical Transcatheter Aortic Valve Replacement. JACC Cardiovasc Interv 2012; 5:e37-8. [DOI: 10.1016/j.jcin.2012.08.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2012] [Accepted: 08/02/2012] [Indexed: 10/27/2022]
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16
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Krapivsky A, Altilar T, Vockelmann C, Niroomand F. [Hemolytic anemia due to silent left ventricular rupture after stent thrombosis]. Herz 2012. [PMID: 23179051 DOI: 10.1007/s00059-012-3717-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 51-year-old woman with known ischemic cardiomyopathy presented to the family doctor for investigation of mild anemia. A routinely performed computed tomography of the abdomen resulted in the suspicion of intracardiac thrombi. The subsequent cardiac examinations showed a pseudoaneurysm of the left ventricle as a result of a silent rupture of a pre-existing left ventricular aneurysm.
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Affiliation(s)
- A Krapivsky
- Klinik für Kardiologie, Evangelisches Krankenhaus Mülheim, Wertgasse 30, 45468, Mülheim an der Ruhr, Deutschland
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Subban V, Kurian VM, Ajit MS, Kumar RS. Hybrid trans-apical device closure of left ventricular pseudoaneurysm under trans-oesophageal echocardiographic guidance. Heart Lung Circ 2012; 21:734-6. [PMID: 22542515 DOI: 10.1016/j.hlc.2012.04.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2012] [Revised: 03/30/2012] [Accepted: 04/03/2012] [Indexed: 11/30/2022]
Abstract
Left ventricular pseudo aneurysm (LVPA) results from contained left ventricular free wall rupture following either myocardial infarction or cardiac surgery. Untreated LVPA carries approximately 30-45% risk of rupture in the first year. Conventional treatment for LVPA is surgery which carries a mortality of about 20%. Interventional closure of LVPA has been reported from trans-arterial and trans-apical routes. Here we report successful hybrid closure of a LVPA under trans-oesophageal echocardiogram (TEE) guidance.
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Affiliation(s)
- Vijayakumar Subban
- Department of Cardiology, Institute of Cardio-Vascular Diseases, Madras Medical Mission, Chennai, India
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Transcatheter closure of a large left ventricular pseudoaneurysm using an Amplatzer Vascular Plug 4 and stenting of the inferior caval vein in a child. Cardiol Young 2012; 22:106-9. [PMID: 21740605 DOI: 10.1017/s1047951111000862] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Left ventricular pseudoaneurysm is especially rare in childhood, and its main treatment option should be surgery. We describe the case of a 9.5-year-old boy who first underwent mitral vegetation excision and then an unsuccessful pseudoaneurysm operation. Owing to pseudoaneurysmal sac dimensions, inferior caval vein syndrome developed. We delivered the Amplatzer Vascular Plug 4 into the pseudoaneurysm and treated the inferior caval vein syndrome with a bare Cheatham-Platinum stent. The patient was asymptomatic at the last follow-up.
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Lopes R, Almeida J, Silva JC, Almeida PB, Madureira AJ, Ramos I, Pinho P, Maciel MJ. Spontaneous closure of a left ventricle pseudoaneurysm following apical venting. ACTA ACUST UNITED AC 2010; 12:E6. [DOI: 10.1093/ejechocard/jeq102] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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