Spontaneous Closure of Pseudoaneurysm After Transapical Aortic Valve Implantation

Miranda, N.; Araji, Omar; Gutiérrez-Martín, María A.; Rodríguez-Caulo, Emiliano A.; Barquero, José M.; Valenzuela, Luis Francisco Labé

doi:10.1016/j.athoracsur.2011.02.023

Cited by 6 publications

(5 citation statements)

References 6 publications

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“…However, TaTEVAR is not well known. Although no access issues have been described so far during TaTEVAR, complications related to the transapical thoracic endovascular aortic valve repair remain a concern, including bleeding from the LV apex, formation of an LV apex pseudoaneurysm, and development of a late ventricular septal defect 7, 8, 9. Our patient had no related symptoms and no evidence of complications on immediate CT, and a follow-up CT scan 4 years later showed full resolution of the dissection.…”

Section: Discussionmentioning

confidence: 65%

Transapical endovascular repair of iatrogenic type A aortic dissection

Kim

Ducaud

Herrera

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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Intraoperative iatrogenic type A aortic dissection is a rare but known complication of cardiac surgery, with an incidence of 0.06% to 0.23%. Results are frequently catastrophic. The endovascular approach has made advances as an alternative treatment for aortic disease. However, the apical approach for transcatheter thoracic endovascular aortic repair is not well known. We present a 5-year follow-up of a case of iatrogenic type A aortic dissection after minimally invasive mitral valve repair successfully resolved by medical stabilization and subsequent transapical thoracic endovascular aortic repair.

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Section: Discussionmentioning

confidence: 65%

Transapical endovascular repair of iatrogenic type A aortic dissection

Kim

Ducaud

Herrera

et al. 2018

Journal of Vascular Surgery Cases, Innovations and Techniques

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“…LVP following TA‐TAVR is a rare complication: the incident rate is 1‐6.6% , but there may be increasing number with expansion of TAVR procedures. In post‐TAVR patients, a few LVP cases have been reported in which they were treated conservatively, and there was one case spontaneously closed at 6 month later . However LVP is considered as a life‐threatening phenomenon: untreated LVP has 30–45% risk of rupture and with medical therapy the mortality is 48% .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous transapical pseudoaneurysm closure following transcatheter aortic valve replacement

Okuyama

Chakravarty

Makkar

2016

Cathet Cardio Intervent

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Left ventricular pseudoaneurysm (LVP) formation is a rare but potentially life-threatening complication of transapical transcatheter aortic valve replacement (TAVR). Conventionally, a pseudoaneurysm has been treated surgically; however, improved transcatheter technique and device technology have made a percutaneous closure of LVP an increasingly viable option, especially in a patient unfavorable for surgery. A TAVR candidate is most likely at increased surgical-risk or inoperable. Therefore a percutaneous closure can be a reasonable strategy for LVP, but its experience following this emerging aortic valve procedure remains limited. We describe a case of LVP formation after TAVR in which it was efficiently treated with a percutaneous closure using a transapical approach via LVP. The first attempt was performed with a transfemoral approach. Pre-closure angiography revealed an eccentric shape of a LVP neck like a "chicken leg". This shape caused serious difficulty to cross LVP with a wire and it was not accomplished. However, the LVP location was at the apex and we could access from a chest wall through the pseudoaneurysm in the second attempt. This approach allowed a close and coaxial wire manipulation and the neck of LVP was finally crossed. After that, a closure device was deployed and the second procedure was successfully completed. An approach selection often contributes to a procedural success. This is the first case of a percutaneous LVP closure following TAVR using a transapical access and may suggest this approach as a possible option for this catheter closure in TAVR candidates. © 2016 Wiley Periodicals, Inc.

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“…LV apical pseudoaneurysms have been treated by a variety of approaches, including conservative management , surgery , and closure devices . A variety of devices have been used successfully for percutaneous closure (Table ).…”

Section: Discussionmentioning

confidence: 99%

“…Over the last several years, LV apical pseudoaneurysm has been recognized as an infrequent complication of transcatheter aortic valve replacement (TAVR) via the apical route, occurring in less than 1% of cases. Given the large number of TAVR procedures, several reports of this complication have been published (Table ) . Treatment for apical pseudoaneurysm has typically been surgical, and several of the reported cases following TAVR have had surgical therapy.…”

Section: Introductionmentioning

confidence: 99%

Percutaneous closure of post TAVR LV apical pseudoaneurysm

Feldman

Pearson

Smart

2015

Cathet Cardio Intervent

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Left ventricular (LV) apical pseudoaneurysm is a well known complication of myocardial infarction and open heart surgery procedures, and has more recently been described after transapical transcatheter aortic valve replacement (TAVR). Since the natural history includes a high incidence of cardiac rupture and mortality in the 30-45% range within the first year after diagnosis, surgical repair has been the main therapy. More recently, LV pseudoaneurysms have been closed using percutaneous methods. We describe a post-TAVR pseudoaneurysm for which closure was done via retrograde LV access using a vascular plug, and provide a review of recent literature on closure methods and outcomes. © 2015 Wiley Periodicals, Inc.

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Spontaneous Closure of Pseudoaneurysm After Transapical Aortic Valve Implantation

Cited by 6 publications

References 6 publications

Transapical endovascular repair of iatrogenic type A aortic dissection

Transapical endovascular repair of iatrogenic type A aortic dissection

Percutaneous transapical pseudoaneurysm closure following transcatheter aortic valve replacement

Percutaneous closure of post TAVR LV apical pseudoaneurysm

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