Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2015;68:1176 - Vol. 68 Num.12 DOI: 10.1016/j.rec.2015.03.013

Percutaneous Closure of an Ascending Aortic Pseudoaneurysm

Eulogio García a, Leire Unzué a,, María Soledad Fernández López-Peláez b

a Unidad de Cardiología Intervencionista, Hospital Universitario Madrid-Montepríncipe, Boadilla del Monte, Madrid, Spain
b Servicio de Radiodiagnóstico, Hospital Universitario Madrid-Montepríncipe, Boadilla del Monte, Madrid, Spain

Article

Pseudoaneurysm of the ascending aorta is a rare but potentially lethal complication arising after interventions involving surgical manipulation of the aorta. The classic therapeutic management strategy consists of high-risk surgical reintervention. In recent years, percutaneous treatment has emerged as an alternative to surgery. Here, we present a case of successful repair of an aortic pseudoaneurysm by percutaneous intervention.

An 81-year-old woman presented with persistent chest pain 3 weeks after surgical replacement of the aortic valve. Thoracic computed tomography revealed a pseudoaneurysm of the ascending aorta measuring 40 × 27 mm, with a narrow neck connected to the anterior face of the aorta (Ao) above the level of the pulmonary artery (PA) and the left main coronary artery (LMCA) (Figure 1). The case was discussed in a medical-surgical session, and a decision was made to perform percutaneous closure of the pseudoaneurysm. An aortogram showed a rounded cavity connected to the ascending aorta (Figure 1); a hydrophilic guidewire was advanced into the interior of the cavity until various loops formed (Figure 1). An 8-mm Amplatzer Vascular Plug II (St. Jude Medical, Inc., St. Paul, Minnesota, United States) was subsequently implanted via a right coronary diagnostic catheter, with a good angiographic result (Figure 2). A postprocedure computed tomography scan showed good positioning of the device, with complete occlusion of the pseudoaneurysm (Figure 2).

Figure 1.

Figure 2.

Corresponding author: leireunzue@yahoo.es

1885-5857/© 2015 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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