Closure Of Left Ventricular Pseudoaneurysm Research Articles

A case report of percutaneous closure of left ventricular pseudoaneurysm

A case report of percutaneous closure of left ventricular pseudoaneurysm

Percutaneous closure of left ventricular pseudoaneurysm. How would I approach it?

Percutaneous closure of left ventricular pseudoaneurysm. How would I approach it?

Percutaneous closure of left ventricular pseudoaneurysm. Case resolution

Percutaneous closure of left ventricular pseudoaneurysm. Case resolution

Percutaneous closure of left ventricular pseudoaneurysm after direct surgical mitral valve implantation of balloon-expandable transcatheter prosthesis in severe mitral annular calcification.

Percutaneous closure of left ventricular pseudoaneurysm after direct surgical mitral valve implantation of balloon-expandable transcatheter prosthesis in severe mitral annular calcification.

Three‐dimensional cardiac print assisted percutaneous closure of left ventricular pseudoaneurysm in patient with Behçet's disease

Spontaneous left ventricular pseudoaneurysms are very rare and can have catastrophic consequences if unrecognized. A case of combined spontaneous left ventricular aneurysm and pseudoaneurysm in Behcet's disease (BD) has been reported. The case emphasizes advanced techniques for percutaneous closure of the defects with the use of an ex-vivo three-dimensional cardiac printed model as a tool to facilitate the procedure.

INSIDE OUT: LEFT VENTRICULAR ANEURYSM FOLLOWING TRANSCATHETER AORTIC VALVE REPLACEMENT

SESSION TITLE: Fellows Cardiovascular Disease Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: A ventricular aneurysm is a defect in the ventricle of the heart, usually produced by transmural infarction. In the heart, they usually arise from a patch of weakened tissue in a ventricular wall. Ventricular aneurysms can lead to complications and even death. CASE PRESENTATION: An 86-year-old female underwent transapical transcatheter aortic valve replacement (TAVR) for critical aortic stenosis. On post-operative day 2, transthoracic echocardiogram (TTE) findings demonstrated a anechoic loculated collection measuring 3.1x4.5cm in apical region suggestive of pseudoanuerysm confirmed by color Doppler imaging (Figure 1: A & B). 3D computed tomography revealed a pseudoaneurysm along the distal anterior wall measuring 5.19cm x 2.98cm x 6.2cm (Figure 1: C). The patient subsequently underwent pseudoaneurysm closure with a 10mm ventricular septal defect (VSD) closure device via amplatz delivery sheath with minimal extravasation of contrast into aneurysmal sac (Figure 2). Follow up transthoracic echocardiogram with color Doppler confirmed successful placement of VSD closure device without evidence of color flow across the device (Figure 3). Patient was evaluated three months later at routine outpatient follow up by TTE without interval change and marked improvement of symptoms. DISCUSSION: Left ventricular pseudoaneurysm is commonly associated with complications following myocardial infarction, surgical valve replacement, thoracic aortic surgery and endocarditis. Pseudoaneurysm following TAVR has a reported incidence rate of less than 1%. Coil embolization and septal occlusion devices provide the safest therapeutic option. To this date, 11 reported cases involving percutaneous closure of left ventricular pseudoaneurysm exist. CONCLUSIONS: Our case depicts the feasibility of successful percutaneous intervention of a left ventricular pseudoaneurysm under conscious sedation with fluoroscopic and TTE guidance. Reference #1: Clift, P., Thorne, S., & De Giovanni, J. (2004). Percutaneous device closure of a pseudoaneurysm of the left ventricular wall. Heart, 90(10), e62-e62. Reference #2: Kumar, P. V., Alli, O., Bjarnason, H., Hagler, D. J., Sundt, T. M., & Rihal, C. S. (2012). Percutaneous therapeutic approaches to closure of cardiac pseudoaneurysms. Catheterization and Cardiovascular Interventions, 80(4), 687-699. Reference #3: Zoffoli G, Mangino D, Venturini A, et al. (February 2009). "Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature". J Cardiothorac Surg. DISCLOSURES: No relevant relationships by Sebastian Carrasquillo, source=Web Response No relevant relationships by Maedeh Ganji, source=Web Response No relevant relationships by Jose Ruiz-Morales, source=Web Response No relevant relationships by Daniel Soffer, source=Web Response

経カテーテル大動脈弁留置術（心尖部アプローチ）後に発症した左室仮性瘤を経カテーテル的に治療した症例の麻酔経験

経カテーテル大動脈弁留置術（心尖部アプローチ）後に発症した左室仮性瘤を経カテーテル的に治療した症例の麻酔経験

Hemolytic Hyperbilirubinemia After Percutaneous Device Closure of Left Ventricular Pseudoaneurysm: A Disregarded Complication

Surgical repair of a left ventricular pseudoaneurysm is challenging. Percutaneous closure with an AMPLATZER Septal Occluder (AGA Medical Corporation, Golden Valley, MN) has evolved to be an effective alternative to conventional surgery with less complication. We report a case of severe hemolytic hyperbilirubinemia and acute renal failure after percutaneous left ventricular pseudoaneurysm endoprothesis repair, which required conventional surgical repair through a left thoracotomy to treat this complication. The rationale and results of such an off-the-label usage of AMPLATZER Septal Occluder were reexamined. Residual leakages were not rare findings in the reviewed literature. The indications for this approach should be individualized.

Percutaneous Closure of Left Ventricular Pseudoaneurysm

Left ventricular pseudoaneurysm is a rare but serious complication from myocardial infarction and cardiac surgery. Although standard treatment is surgical intervention, percutaneous closure of left ventricular pseudoaneurysm has become an option for high-risk surgical candidates. Experience with percutaneous treatment is limited to a few single case reports. This is the first series of percutaneous treatment of the left ventricular pseudoaneurysms. This is a retrospective analysis of 9 procedures of percutaneous repair of left ventricular pseudoaneurysm in 7 consecutive patients (ages 51 to 83 years, 6 men) completed in our Structural Heart Disease center from June 2008 to December 2010. All patients were considered as a high risk for surgery because of multiple comorbidities. Multiple imaging modalities were used before, during, and after the procedures to improve success and efficacy. The left ventricular pseudoaneurysms of all 7 patients were successfully repaired. Fluoroscopy time on average was 36.5±24.0 minutes (range, 12.4 to 75.7 minutes). All patients were followed up for a period ranging from 3 to 32 months after the procedure. Each patient improved by at least 1 New York Heart Association functional class, and 4 patients improved by 2 classes. Transcatheter closure of the left ventricular pseudoaneurysm is a feasible alternative for high-risk surgical candidates. The use of multiple imaging modalities is required for a detail planning and execution of the procedure.

PP-150 PERCUTANEOUS EXTRACTION OF CARDIAC PACEMAKER AND IMPLANTABLE CARDIOVERTER DEFIBRILLATOR LEADS WITH A NEW TOOL; A SINGLE CENTER EXPERIENCE

Methods: A 70 year old man who presented with a history of class II heart failure was found to have a left ventricular pseudoaneurysm. Cardiac magnetic resonance angiography and echocardiography showed a large pseudoaneurysm with a neck of approximately 24 mm, and a high velocity bi-directional jet between the posterolateral wall of the left ventricle (LV) and a vast sump. Hand contrast angiography together with conventional angiography confirmed a communication between the LV cavity and a large false cavity. A trans-septal catheterization was deemed suitable as the delivery catheter length would preclude a femoral arterial approach. Results: A 24 mm Amplatzer sizing balloon was advanced into the pseudoaneurysm cavity which sized the orifice at 22 mm. A 10 French Amplatzer sheath was passed through the defect and a 26 mm Amplatzer septal occluder was deployed across the defect (1F). We noticed a collapse in the center of the discus deployed on the ventricular site suggesting that the design of the device may not be strong enough to withstand the pressure difference. Upon release of the delivery system, the device was dislocated. We attempted to retrieve the device with a snare catheter but we were unsuccessful. Afterwards the patient was given to surgery for device removal, and pseudoaneurysm resection. Unfortunately he died during early post-operative period. Conclusions: The novel and important aspects of our intervention is that a femoral vein approach with trans-septal puncture is safe and effective for percutaneous closure of a left ventricular pseudoaneurysm. We recommend a gentile Minnesota maneuver to be employed just to make sure releasing the delivery system is safe. A different Amplatzer device with a more robust design on one discus, which would be deployed on the ventricular site could be more appropriate for closure of a larger left ventricular pseudoaneurysm.

PP-151 THE SAFETY AND EFFICACY OF THE ANGIO-SEAL CLOSURE DEVICE IN DIAGNOSTIC AND INTERVENTIONAL CARDIOLOGY SETTING: PRELIMINARY RESULTS OF SINGLE-CENTER EXPERIENCE WITH 551 CLOSURES

Methods: A 70 year old man who presented with a history of class II heart failure was found to have a left ventricular pseudoaneurysm. Cardiac magnetic resonance angiography and echocardiography showed a large pseudoaneurysm with a neck of approximately 24 mm, and a high velocity bi-directional jet between the posterolateral wall of the left ventricle (LV) and a vast sump. Hand contrast angiography together with conventional angiography confirmed a communication between the LV cavity and a large false cavity. A trans-septal catheterization was deemed suitable as the delivery catheter length would preclude a femoral arterial approach. Results: A 24 mm Amplatzer sizing balloon was advanced into the pseudoaneurysm cavity which sized the orifice at 22 mm. A 10 French Amplatzer sheath was passed through the defect and a 26 mm Amplatzer septal occluder was deployed across the defect (1F). We noticed a collapse in the center of the discus deployed on the ventricular site suggesting that the design of the device may not be strong enough to withstand the pressure difference. Upon release of the delivery system, the device was dislocated. We attempted to retrieve the device with a snare catheter but we were unsuccessful. Afterwards the patient was given to surgery for device removal, and pseudoaneurysm resection. Unfortunately he died during early post-operative period. Conclusions: The novel and important aspects of our intervention is that a femoral vein approach with trans-septal puncture is safe and effective for percutaneous closure of a left ventricular pseudoaneurysm. We recommend a gentile Minnesota maneuver to be employed just to make sure releasing the delivery system is safe. A different Amplatzer device with a more robust design on one discus, which would be deployed on the ventricular site could be more appropriate for closure of a larger left ventricular pseudoaneurysm.