1
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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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Sonawane B, Sivakumar K. A giant left ventricular pseudoaneurysm diagnosed after double-valve replacement. Asian Cardiovasc Thorac Ann 2020; 29:953-956. [PMID: 33342220 DOI: 10.1177/0218492320983490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A diagnostic coronary catheter injury to the subaortic region in a 41-year-old woman with rheumatic heart disease led to a pseudoaneurysm that later caused extrinsic left coronary compression. She subsequently underwent double-valve replacement, overlooking the pseudoaneurysm that enlarged to a giant size three months later following thrombolysis for mitral prosthesis thrombosis. A thrombolysis-induced large intracerebral hemorrhage posed a significant risk for reoperation, and mechanical prosthetic valves in the aortic and mitral positions allowed a catheter option only, through percutaneous transapical access. Interventional closure of the pseudoaneurysm is discussed in this unique report.
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Affiliation(s)
- Bhushan Sonawane
- Department of Cardiology, Madras Medical Mission, Chennai, India
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4
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Zhong W, Liu Z, Fan W, Ou B, Zhong M, Zeng Z, Wang X, Aronow WS, Nappi F, Lacalzada-Almeida J, Zhong Z. Transcatheter closure for the treatment of pseudoventricular aneurysm after acute myocardial infarction: a case report. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:1528. [PMID: 33313273 PMCID: PMC7729332 DOI: 10.21037/atm-20-6335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Left ventricular free wall rupture (LVFWR) is a rare but lethal complication of acute myocardial infarction (AMI). Urgent surgery is essential but associated with high postoperative mortality. Even worse, LVFWR patients may experience sudden death without a chance for surgery. In this article, we report our successful transcatheter closure of a patient with the most extensive pseudoventricular aneurysm after AMI reported thus far. Cardiac magnetic resonance imaging (MRI) revealed a giant pseudoventricular aneurysm located in the inferior and lateral walls of the left ventricle; the rupture diameter was 28 mm, and the maximum tumor diameter was 90.2 mm. We used transcarotid approach (TCA) and atrial septal defect closure umbrella to complete the operation, which solved the lack of special interventional instruments to treat pseudoventricular aneurysm after AMI. In addition, we still needed to treat liver and kidney failure caused by hemolysis after operation, and undergone strict follow-up. In conclusion, transcatheter closure is practical and feasible for the treatment of pseudoventricular aneurysm after AMI, although hemolysis and decline of cardiac pumping function after the successful interventional treatment deserve special attention. Future multicenter studies are required to identify patients best suited for interventional treatment timing. And further developments in devices and delivery techniques are required in order to optimize interventional outcomes.
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Affiliation(s)
- Wei Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Zhidong Liu
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Weixiong Fan
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China.,Magnetic Resonance Department, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China
| | - Bin Ou
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Min Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Zhiwen Zeng
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Xianfang Wang
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
| | - Wilbert S Aronow
- Cardiology Department, Westchester Medical Center and New York Medical College, Valhalla, NY, USA
| | - Francesco Nappi
- Department of Cardiac Surgery, Centre Cardiologique du Nord de Saint-Denis, Paris, France
| | - Juan Lacalzada-Almeida
- Cardiac Imaging Laboratory, Department of Cardiology, University Hospital of Canary Islands, La Cuesta, La Laguna, Tenerife, Spain
| | - Zhixiong Zhong
- Center for Cardiovascular Diseases, Meizhou People's Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University, Meizhou, China.,Guangdong Provincial Engineering and Technology Research Center for Molecular Diagnostics of Cardiovascular Diseases, Meizhou, China.,Guangdong Provincial Key Laboratory of Precision Medicine and Clinical Translational Research of Hakka Population, Meizhou, China
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5
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Arnaz A, Akansel S, Yalcinbas Y, Saygili A, Sarioglu T. Transcatheter Closure of Left Ventricular Pseudoaneurysm After Mitral Valve Replacement. Ann Thorac Surg 2020; 110:e123-e125. [PMID: 31982444 DOI: 10.1016/j.athoracsur.2019.12.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Revised: 11/27/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
Left ventricular pseudoaneurysm (LVPA) is a rare but lethal complication of mitral valve replacement (MVR) or myocardial infarction. Early correction is necessary for patients with extensive and expanding LVPA. We report a transcatheter closure of LVPA after MVR. A 63-year-old woman presented with an LVPA 2 months after MVR. The repeated computed tomographic scan and transthoracic echocardiography showed enhancement of pseudoaneurysm. The LVPA was closed successfully with Amplatzer Vascular Plug using a transcatheter approach.
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Affiliation(s)
- Ahmet Arnaz
- Department of Cardiovascular Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey.
| | - Serdar Akansel
- Department of Cardiovascular Surgery, Istanbul Taksim Training and Research Hospital, Istanbul, Turkey
| | - Yusuf Yalcinbas
- Department of Cardiovascular Surgery, Acibadem Bakirkoy Hospital, Istanbul, Turkey
| | - Arda Saygili
- Department of Pediatric Cardiology, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
| | - Tayyar Sarioglu
- Department of Cardiovascular Surgery, School of Medicine, Acibadem Mehmet Ali Aydinlar University, Istanbul, Turkey
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6
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Uccheddu F, Gallo M, Nocerino E, Remondino F, Stolocova M, Meucci F, Di Mario C, Gerosa G. Cardiovascular interventions planning through a three-dimensional printing patient-specific approach. J Cardiovasc Med (Hagerstown) 2019; 20:584-596. [DOI: 10.2459/jcm.0000000000000832] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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7
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Tang L, Tang JJ, Hu XQ, Fang ZF, Zhu ZW, Chen YQ, Zhao YS, Peng R, Zhou SH. Transcatheter Closure of Complex Post-Myocardial Infarction Left Ventricular Pseudoaneurysm and Unique Post-Traumatic Right Ventricular Pseudoaneurysm. Int Heart J 2019; 60:998-1002. [PMID: 31257334 DOI: 10.1536/ihj.18-577] [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] [Indexed: 11/18/2022]
Abstract
Ventricular pseudoaneurysm (PSA) is a rare, yet life-threatening complication of myocardial infarction, cardiac surgery, and transcatheter valve replacement. Although conventional surgery is the preferred treatment strategy, transcatheter closure has emerged as an effective alternative in selected candidates. In this report, we describe successful transcatheter closure of two unique cases of ventricular pseudoaneurysm (PSA): first, a complex post-myocardial infarction left ventricular PSA (LVPSA) with multi-communications, and second, a case of post-traumatic right ventricular PSA (RVPSA) following blunt chest injury caused by domestic violence.
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Affiliation(s)
- Liang Tang
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Jian-Jun Tang
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Xin-Qun Hu
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Zhen-Fei Fang
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Zhao-Wei Zhu
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Ya-Qin Chen
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Yan-Shu Zhao
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Ran Peng
- Department of Cardiology, The Second Xiangya Hospital of Central South University
| | - Sheng-Hua Zhou
- Department of Cardiology, The Second Xiangya Hospital of Central South University
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8
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Sawlani N, Berry N, Sobieszczyk P, Kaneko T, Pelletier M, Shah P. Percutaneous Closure of a Delayed Left Ventricular Pseudoaneurysm After Transseptal Transcatheter Mitral Valve Replacement. JACC Cardiovasc Interv 2017; 10:1464-1465. [DOI: 10.1016/j.jcin.2017.03.045] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Accepted: 03/24/2017] [Indexed: 11/24/2022]
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9
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Chandrashekar R, Konda MK, Gupta V, Kalavakunta JK. Left Ventricular Pseudoaneurysm Dissecting into the Anterior Chest Wall: A Rare Cause of Sudden Onset Excruciating Chest Pain. Eur J Case Rep Intern Med 2017; 4:000518. [PMID: 30755908 PMCID: PMC6346915 DOI: 10.12890/2016_000518] [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: 10/24/2016] [Accepted: 11/02/2016] [Indexed: 11/05/2022] Open
Abstract
Left ventricular pseudoaneurysm (LVPA) is associated with a significant mortality rate of up to 45% in the first year after diagnosis. It is a very rare entity and hence the true incidence and natural history are not clearly known. Clinical presentation varies widely and requires a high index of suspicion for diagnosis. We report the case of a 72-year-old woman with a remote history of left ventricular aneurysm repair during coronary bypass surgery who presented to the emergency department with acute onset of left-sided chest pain and a pulsatile chest wall swelling. She was haemodynamically stable but required an intravenous morphine drip for pain control. Contrast-enhanced computed tomography of the chest showed a large LVPA dissecting through the anterior chest wall. Surgical treatment was discussed with the patient but she opted in favour of comfort care. She died 5 days later from complete rupture of the LVPA. With this report, we aim to raise the level of awareness of LVPA that could anatomically expand and rupture. Early diagnosis and timely surgical intervention is the treatment of choice.
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Affiliation(s)
| | - Monoj Kumar Konda
- Department of Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, MI, USA
| | - Vishal Gupta
- Department of Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, MI, USA.,Department of Cardiology, Michigan State University/Borgess Medical Center, Kalamazoo, MI, USA
| | - Jagadeesh K Kalavakunta
- Department of Internal Medicine, Western Michigan University School of Medicine, Kalamazoo, MI, USA.,Department of Cardiology, Michigan State University/Borgess Medical Center, Kalamazoo, MI, USA
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10
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Langer NB, Hamid NB, Nazif TM, Khalique OK, Vahl TP, White J, Terre J, Hastings R, Leung D, Hahn RT, Leon M, Kodali S, George I. Injuries to the Aorta, Aortic Annulus, and Left Ventricle During Transcatheter Aortic Valve Replacement. Circ Cardiovasc Interv 2017; 10:CIRCINTERVENTIONS.116.004735. [DOI: 10.1161/circinterventions.116.004735] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The experience with transcatheter aortic valve replacement is increasing worldwide; however, the incidence of potentially catastrophic cardiac or aortic complications has not decreased. In most cases, significant injuries to the aorta, aortic valve annulus, and left ventricle require open surgical repair. However, the transcatheter aortic valve replacement patient presents a unique challenge as many patients are at high or prohibitive surgical risk and, therefore, an open surgical procedure may not be feasible or appropriate. Consequently, prevention of these potentially catastrophic injuries is vital, and practitioners need to understand when open surgical repair is required and when alternative management strategies can be used. The goal of this article is to provide an overview of current management and prevention strategies for major complications involving the aorta, aortic valve annulus, and left ventricle.
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Affiliation(s)
- Nathaniel B. Langer
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Nadira B. Hamid
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Tamim M. Nazif
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Omar K. Khalique
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Torsten P. Vahl
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Jonathon White
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Juan Terre
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Ramin Hastings
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Diana Leung
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Rebecca T. Hahn
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Martin Leon
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Susheel Kodali
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
| | - Isaac George
- From the Division of Cardiothoracic Surgery (N.B.L., D.L., I.G.) and Division of Cardiology (N.B.H., T.M.N., O.K.K., T.P.V., J.W., J.T., R.H., R.T.H., M.L., S.K., I.G.), Columbia University College of Physicians and Surgeons, New York, NY
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11
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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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12
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Tsai IC, Lin MC, Jan SL, Fu YC. Multidetector Row Computed Tomography for Percutaneous Closure of a Left Ventricular Free Wall Rupture After Myocardial Infarction. JACC Cardiovasc Interv 2016; 8:e175-e176. [PMID: 26404207 DOI: 10.1016/j.jcin.2015.04.024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 04/25/2015] [Indexed: 10/23/2022]
Affiliation(s)
- I-Chen Tsai
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China; Department of Radiology, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | - Ming-Chih Lin
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China; Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | - Sheng-Ling Jan
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China; Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China
| | - Yun-Ching Fu
- Department of Pediatrics and Institute of Clinical Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China; Section of Pediatric Cardiology, Department of Pediatrics, Taichung Veterans General Hospital, Taichung, Taiwan, Republic of China.
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13
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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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14
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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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15
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Moriarty J, Harris TJ, Vorobiof G, Kwon M, Aboulhosn J. Direct Percutaneous Repair of Left Ventricular Pseudoaneurysm via Transthoracic Deployment of a Ventricular Septal Defect Closure Device. Tex Heart Inst J 2015; 42:362-6. [PMID: 26413020 DOI: 10.14503/thij-14-4243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
In this case report, we describe direct percutaneous delivery of a muscular-ventricular-septal-defect occluder device to close a left ventricular pseudoaneurysm. The occluder was positioned and deployed with the aid of concurrent transthoracic ultrasonography, transesophageal echocardiography, and fluoroscopy. In contrast with previously published reports, we describe and illustrate a direct transthoracic route across the pseudoaneurysmal sac, which obviated the need for indirect transfemoral or transapical approaches.
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16
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Kronzon I, Ruiz CE, Perk G. Guidance of post myocardial infarction ventricular septal defect and pseudoaneurysm closure. Curr Cardiol Rep 2014; 16:456. [PMID: 24473966 DOI: 10.1007/s11886-013-0456-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Left ventricular pseudoaneurysm and ventricular septal defect are rare but devastating complications of myocardial infarction. With medical treatment alone, the majority of patients will die from these complications. Until recently, the recommended treatment was surgical closure. These surgeries carried extreme risk due to abnormal hemodynamics, necrotic substrates and the comorbidities of these patients. Recently, trans-catheter closure was shown to be an acceptable alternative to open surgical intervention. 3D echocardiography identifies the location, size, and shape of the defect and can assess, guide, and follow up the closure procedure.
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Affiliation(s)
- Itzhak Kronzon
- Non Invasive Cardiology, Lenox Hill Hospital, 100 E 77th St. 2E, New York, NY, 10075, USA
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