Percutaneous Closure of Left Ventricular Pseudoaneurysm

Dudiy, Yuriy; Jelnin, Vladimir; Einhorn, Bryce; Kronzon, Itzhak; Cohen, Howard A.; Ruiz, Carlos E.

doi:10.1161/circinterventions.111.962464

Cited by 107 publications

(106 citation statements)

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“…3,4,8,9 Transapical repair of an ascending aortic pseudoaneurysm has been reported, 10 and direct percutaneous puncture of the pseudoaneurysmal sac has been described in 2 patients, 5 although images were not provided and the causes and anatomic locations of these pseudoaneurysms were at variance with our case. In our patient, anatomic considerations favored a direct percutaneous approach through the pseudoaneurysmal sac; the 2-to 3-mm defect along the anterior free wall would have been an extremely challenging target via a transfemoral approach, particularly in a beating heart.…”

Section: Discussionmentioning

confidence: 61%

“…1,2 More recently, multiple authors have described endovascular repair with use of a ventricular septal defect (VSD) Amplatzer ® occluder device (St. Jude Medical, Inc.; St. Paul, Minn) deployed via a transarterial route 3 or a transvenous route. 4 Dudiy and colleagues 5 have described a transapical approach through the pseudoaneurysmal sac, in 2 patients; however, no images of this approach were provided. We report our initial experience with this technique.…”

mentioning

confidence: 99%

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Direct Percutaneous Repair of Left Ventricular Pseudoaneurysm via Transthoracic Deployment of a Ventricular Septal Defect Closure Device

Moriarty¹,

Harris²,

Vorobiof³

et al. 2015

Texas Heart Institute Journal

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In this case report, we describe direct percutaneous delivery of a muscular-ventricularseptal-defect 4 Dudiy and colleagues 5 have described a transapical approach through the pseudoaneurysmal sac, in 2 patients; however, no images of this approach were provided. We report our initial experience with this technique. Case ReportIn January 2012, a 72-year-old woman initially underwent cardiopulmonary bypass for open graft repair of an ascending aortic dissection, at another hospital. The procedure was complicated by ventricular fibrillation arrest and anterior myocardial infarction. Over the course of the next year, she underwent multiple endovascular procedures for the management of sequelae of a continuous descending and abdominal aortic dissection.In April 2013, the patient underwent open surgical repair (with insertion of a descending aortic graft) of persistent type II endoleaks that had occurred proximally and distally in the thoracic aorta. She then experienced knee numbness, which was attributed to spinal ischemia. At the time, no further sequelae of the aortic procedure-or of cardiopulmonary bypass, including LV cannulation-were noted. However, one month after the surgical procedure the patient developed persistent band-like pain across the lower chest. This prompted contrast-enhanced computed tomographic angiography (CTA), which revealed a large pseudoaneurysm arising from the anterior wall of the LV and surrounding, but discrete from, the left anterior descending coronary artery (LAD) (Fig. 1). The patient then presented at the Interventional Radiology Section for consultation.Given the patient's pain (as illuminated by our subsequent CTA discovery of the large LV pseudoaneurysm), we decided to proceed with closure. Because of scant published experience with the treatment of such a condition, we consulted local specialists in congenital cardiology, cardiothoracic surgery, and interventional cardiology, in order to select the optimal equipment and approach. Rejected options included 1) surgical closure (because of the patient's refusal-together with the high morbidity and mortality rates associated with repeat sternotomy and repair); 2) transfemoral clo-

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Section: Discussionmentioning

confidence: 61%

mentioning

confidence: 99%

Direct Percutaneous Repair of Left Ventricular Pseudoaneurysm via Transthoracic Deployment of a Ventricular Septal Defect Closure Device

Moriarty¹,

Harris²,

Vorobiof³

et al. 2015

Texas Heart Institute Journal

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“…Surgical procedures, closure of the aneurysm's orifice through c-endocardial or epicardial approach (9). Transcatheter closure of the left ventricular pseudoaneurysm is a feasible alternative for high-risk surgical candidates (10).…”

Section: Discussionmentioning

confidence: 99%

Idiopathic left ventricular pseudo aneurysm that look like left ventricle mass image

Ulucan¹,

Keser²,

Kaya³

et al. 2016

Turk J Bioch

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CaseA 82 year-old female patient admitted to cardiology clinic complain about chest pain, palpitation and dyspnea. The symptoms were exacerbated within 5 days. Hypertension was present as a risk factor. Her blood pressure was 155/95 mmHg, and pulse-rate was regular at a rate 85/min. On Physical examination there was no any significant problem. There was no ischemic sign in the electrocardiography. The transthorasic echocardiography (TTE) examination showed an image that looks like a bulk attached on left ventricular wall (Figure 1-2).

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“…15 Similarly, as a recent alternative to open surgical closure of pseudoaneurysms of the cardiac chambers, there are reports of successful interventional percutaneous techniques of implanting septal occluder devices in atria and ventricles. 8,16 In some instances, treatment with anticoagulation may be required to reduce the risk of thromboembolism. When considering the use of anticoagulation, clinicians must weigh the benefit of reduced thromboembolism related to therapeutic anticoagulation against the risk of bleeding or pseudoaneurysm rupture.…”

Section: Treatmentsmentioning

confidence: 99%