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D'Ortenzio R, Cardarelli-Leite L, Dhatt R, Saw J, Heran M. Transarterial coil embolization of an aortic root pseudoaneurym in a patient with Loeys-Dietz syndrome: a case report. CVIR Endovasc 2020; 3:94. [PMID: 33289867 PMCID: PMC7724013 DOI: 10.1186/s42155-020-00184-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Accepted: 11/29/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Loeys-Dietz syndrome (LDS) is a rare autosomal-dominant connective tissue disorder characterized by arterial aneurysms and vascular friability. Surgical intervention for LDS patients carries significant morbidity and mortality. Currently, the standard management of aortic root pseudoaneurysms is surgical intervention. CASE PRESENTATION A 20 year old male with LDS presented with a progressively enlarging ascending aortic aneurysm. He underwent a Bentall-type aortic root replacement complicated by a 20 mm aortic root anastomotic pseudoaneurysm. Due to the patient's high risk for repeat surgical intervention, he underwent successful transarterial coil embolization of his aortic root pseudoaneurysm without complication. CONCLUSIONS Coil embolization may provide an alternative treatment for patients presenting with aortic root pseudoaneurysm who are high risk for traditional surgical treatment, such as those with connective tissue disease.
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Affiliation(s)
- Robert D'Ortenzio
- Department of Radiology, University of British Columbia, 11th Floor, 2775 Laurel St., Vancouver, V5Z 1M9, Canada.
| | | | - Ravjot Dhatt
- Department of Radiology, University of British Columbia, 11th Floor, 2775 Laurel St., Vancouver, V5Z 1M9, Canada
| | - Jacqueline Saw
- Department of Cardiology, University of British Columbia, 9th Floor, 2775 Laurel St., Vancouver, V5Z 1M9, Canada
| | - Manraj Heran
- Department of Radiology, BC Children's Hospital, 4500 Oak St., Vancouver, BC, V6H 3N1, Canada
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Izzo D, Savino K, Castellani C, Sperandini L, Ragni T, Ambrosio G, Cavallini C. Post-traumatic Aortopulmonary Fistula after Bentall Procedure. J Cardiovasc Echogr 2020; 30:29-32. [PMID: 32766103 PMCID: PMC7307618 DOI: 10.4103/jcecho.jcecho_5_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 02/25/2020] [Accepted: 03/09/2020] [Indexed: 11/29/2022] Open
Abstract
Pseudoaneurysm complicated by aortopulmonary fistula (APF) after a Bentall procedure is extremely rare but potentially fatal, so timely diagnosis and treatment are critical. We present a subacute case of a post-traumatic APF which has had initial aspecific symptoms and later an acute worsening heart failure with chest pain not responding to medical treatment and requiring emergency surgery.
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Affiliation(s)
- Daniela Izzo
- Department of Cardiology and Cardiovascular Physiopathology, University of Perugia, Perugia, Italy
| | - Ketty Savino
- Department of Cardiology and Cardiovascular Physiopathology, University of Perugia, Perugia, Italy
| | | | | | | | - Giuseppe Ambrosio
- Department of Cardiology and Cardiovascular Physiopathology, University of Perugia, Perugia, Italy
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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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4
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Liu Y, Yu S, Li L, Li X, Yang J. Percutaneous closure of tricuspid paravalvular leak without contrast for a patient with renal insufficiency. J Card Surg 2018; 33:90-92. [PMID: 29464797 DOI: 10.1111/jocs.13520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Yang Liu
- Department of Cardiovascular Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, China
| | - Shiqiang Yu
- Department of Cardiovascular Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, China
| | - Lanlan Li
- Department of Cardiovascular Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, China
| | - Xiaofeng Li
- Department of Cardiovascular Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, China
| | - Jian Yang
- Department of Cardiovascular Surgery, Xijing Hospital, Forth Military Medical University, Xi'an, China
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Agematsu K, Okamura T, Takiguchi Y, Harada Y. Cardiac perforation 6 years following the implantation of an Amplatzer septal occluder. J Card Surg 2018; 33:105-106. [PMID: 29460301 DOI: 10.1111/jocs.13540] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kota Agematsu
- Division of Cardiac Surgery, Nagano Children's Hospital, Nagano, Japan
| | - Toru Okamura
- Division of Cardiac Surgery, Nagano Children's Hospital, Nagano, Japan
| | - Yoji Takiguchi
- Division of Cardiac Surgery, Nagano Children's Hospital, Nagano, Japan
| | - Yorikazu Harada
- Division of Cardiac Surgery, Nagano Children's Hospital, Nagano, Japan
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Sugiyama K, Suzuki S, Kamiya K, Koizumi N, Ogino H. Ruptured coronary artery aneurysm with pulmonary artery fistulae. J Card Surg 2017; 32:799-800. [DOI: 10.1111/jocs.13243] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kayo Sugiyama
- Department of Cardiovascular Surgery; Aichi Medical University Hospital; Aichi Japan
| | - Shun Suzuki
- Department of Cardiovascular Surgery; Tokyo Medical University Hospital; Tokyo Japan
| | - Kentaro Kamiya
- Department of Cardiovascular Surgery; Tokyo Medical University Hospital; Tokyo Japan
| | - Nobusato Koizumi
- Department of Cardiovascular Surgery; Tokyo Medical University Hospital; Tokyo Japan
| | - Hitoshi Ogino
- Department of Cardiovascular Surgery; Tokyo Medical University Hospital; Tokyo Japan
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Henley MD, Farber MA, Ikonomidis JS, Kolarczyk LM, Teeter EG, Barrick BP, Caranasos TG, Martinelli SM. A Tale of Three Surgeries: Management of a Massive Recurrent Mycotic Aortic Pseudoaneurysm. J Cardiothorac Vasc Anesth 2017; 32:550-557. [PMID: 29126684 DOI: 10.1053/j.jvca.2017.08.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Indexed: 12/17/2022]
Affiliation(s)
- Megan D Henley
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC.
| | - Mark A Farber
- Department of Surgery, Division of Vascular Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - John S Ikonomidis
- Department of Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Lavinia M Kolarczyk
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Emily G Teeter
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Brian P Barrick
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Thomas G Caranasos
- Department of Surgery, Division of Cardiothoracic Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Susan M Martinelli
- Department of Anesthesiology, University of North Carolina at Chapel Hill, Chapel Hill, NC
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Toušek P, Kočka V, Petr R, Ulman J, Hlavička J, Kolesár M. Use of Amplatzer occluders for treatment of aorto-pulmonary fistulas - case and review of the literature. Expert Rev Med Devices 2017; 14:845-847. [PMID: 29022410 DOI: 10.1080/17434440.2017.1389636] [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] [Indexed: 10/18/2022]
Abstract
INTRODUCTION the use of amplatzer occluder family in daily clinical practice has already overcome on-label indications, with growing clinical experience and the technological evolution of devices. Areas covered: We present the case of a patient with a very rare complication following proximal aortic surgery treated using a unique strategy. A huge pseudoaneurysm around an ascending aortic prosthesis ruptured into the right pulmonary artery. A hybrid treatment strategy consisting of percutaneous closure of the fistula followed by cardiosurgery was chosen due to the patient's poor haemodynamic condition. We also review current clinical experience of endovascular treatment of aortopulmonary fistulas by searching case reports in PubMed. Expert commentary: Closure of the APF using an Amplatzer occluder via the antegrade venous approach is feasible, and may improve the haemodynamic conditions and decrease the risk of subsequent cardiac surgery.
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Affiliation(s)
- Petr Toušek
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
| | - Viktor Kočka
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
| | - Robert Petr
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
| | - Jaroslav Ulman
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
| | - Jan Hlavička
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
| | - Miroslav Kolesár
- a Cardiocenter , University Hospital Královské Vinohrady and Third Faculty of Medicine, Charles University , Prague , Czech Republic
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