Three-dimensional TOE planimetry of aortic annulus improves the assessment of prosthesis/annulus discongruence and predicts the appearance of significant AR after TAVI.

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. © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. PALAVRAS-CHAVEAorta ascendente; Pseudoaneurisma; Encerramento percutâneo Encerramento percutâneo de um volumoso pseudoaneurisma da aorta ascendenteResumo O pseudoaneurisma da aorta ascendente consiste numa complicação rara, habitualmente na sequência de cirurgia cardiotorácica ou traumatismo.Dado que a reparação cirúrgica do mesmo se associa a uma elevada morbimortalidade, o encerramento percutâneo tem vindo a ser descrito como uma alternativa viável. * Corresponding author. E-mail address: marta.afonso.nogueira@gmail.com (M.A. Nogueira). 2174-2049Document downloaded from http://www.elsevier.pt, day 09/03/2016. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 119.e2 M.A. Nogueira et al.Neste contexto, apresentamos um caso caracterizado por um volumoso e sintomático pseudoaneurisma da aorta ascendente, o qual fora submetido a tratamento percutâneo, devido ao elevado risco cirúrgico.Apesar das dificuldades do ponto de vista técnico, este procedimento obteve um bom resultado final, com sucesso em termos clínicos.

Introduction:A growing body of evidence shows the prognostic value of oxygen uptake effi ciency slope (OUES), a cardiopulmonary exercise test (CPET) parameter derived from the logarithmic relationship between O 2 consumption (VO 2 ) and minute ventilation (VE) in patients with chronic heart failure (CHF). Objective: To evaluate the prognostic value of a new CPET parameter -peak oxygen uptake effi ciency (POUE) -and to compare it with OUES in patients with CHF. Methods: We prospectively studied 206 consecutive patients with stable CHF due to dilated cardiomyopathy -153 male, aged 53.3±13.0 years, 35.4% of ischemic etiology, left ventricular ejection fraction 27.7±8.0%, 81.1% in sinus rhythm, 97.1% receiving ACE-Is or ARBs, 78.2% beta-blockers and 60.2% spironolactone -who performed a fi rst maximal symptom-limited treadmill CPET, using the modified Bruce protocol. In 33% of patients an cardioverterdefi brillator (ICD) or cardiac resynchronization therapy device (CRT-D) was implanted during follow-up.Peak VO 2 , percentage of predicted peak VO 2 , VE/VCO 2 slope, OUES and POUE were analyzed. OUES was calculated using the formula VO 2 (l/min) = OUES (log 10 VE) + b. POUE was calculated as pVO 2 (l/min) / log 10 peakVE (l/min). Correlation coeffi cients between the studied parameters were obtained. The prognosis of each variable adjusted for age was evaluated through Cox proportional hazard models and R2 percent (R2%) and V index (V6) were used as measures of the predictive accuracy of events of each of these variables. Receiver operating characteristic (ROC) curves from logistic regression models were used to determine the cut-offs for OUES and POUE. Results: pVO 2 : 20.5±5.9; percentage of predicted peak VO 2 : 68.6±18.2; VE/VCO 2 slope: 30.6±8.3; OUES: 1.85±0.61; POUE: 0.88±0.27. During a mean follow-up of 33.1±14.8 months, 45 (21.8%) patients died, 10 (4.9%) underwent urgent heart transplantation and in three patients (1.5%) a left ventricular assist device was implanted. All variables proved to be independent predictors www.revportcardiol.org

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. © 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier España, S.L.U. All rights reserved. PALAVRAS-CHAVEAorta ascendente; Pseudoaneurisma; Encerramento percutâneo Encerramento percutâneo de um volumoso pseudoaneurisma da aorta ascendenteResumo O pseudoaneurisma da aorta ascendente consiste numa complicação rara, habitualmente na sequência de cirurgia cardiotorácica ou traumatismo.Dado que a reparação cirúrgica do mesmo se associa a uma elevada morbimortalidade, o encerramento percutâneo tem vindo a ser descrito como uma alternativa viável. * Corresponding author. E-mail address: marta.afonso.nogueira@gmail.com (M.A. Nogueira). 2174-2049Document downloaded from http://www.elsevier.pt, day 09/03/2016. This copy is for personal use. Any transmission of this document by any media or format is strictly prohibited. 119.e2 M.A. Nogueira et al.Neste contexto, apresentamos um caso caracterizado por um volumoso e sintomático pseudoaneurisma da aorta ascendente, o qual fora submetido a tratamento percutâneo, devido ao elevado risco cirúrgico.Apesar das dificuldades do ponto de vista técnico, este procedimento obteve um bom resultado final, com sucesso em termos clínicos.

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