Transapical transcatheter device closure of relapse left ventricular diverticulum: a novel minimally invasive technique for reoperation

Abstract

We describe a novel minimally invasive technique, transapical transcatheter device closure of relapse left ventricular diverticulum (LVD) under transesophageal echocardiography (TEE) guidance. The patient previously underwent LVD primary repair and mitral valvular replacement. The anatomical characteristics of the relapse LVD and its adjacent structures are detailedly delineated by echocardiography. The relapse LVD is then managed by transapical transcatheter device closure under TEE guidance. This novel minimally invasive technique is not only limited in relapse LVD, but also could be extensively applied in other cardiac reoperation, such as perivalvular leak closure after valvular replacement.

Partial resection of large congenital left ventricular diverticulum in an infant: a case report

“…To our knowledge, transcatheter device closure of LVD has been reported in only two patients, both of whom had favorable outcomes [9,10] We suspect the transcatheter intervention may require an even smaller connection than direct suturing, such as 0.4 and 0.13 cm in studies of two patients with good outcomes after the transcatheter procedure [9,10]. In the present case, preoperative multidisciplinary discussion including two senior interventional cardiologists resulted in consensus for surgical resection, as the wide diverticulum connection was judged unsuitable for transcatheter intervention.…”