Publish in this journal
Journal Information
Vol. 72. Issue 2.
Pages 164 (February 2019)
Image in cardiology
DOI: 10.1016/j.rec.2018.02.005
Full text access
Percutaneous Closure of a Left Ventricular Outflow Tract Pseudoaneurysm
Cierre percutáneo de seudoaneurisma en tracto de salida de ventrículo izquierdo
Visits
...
Eduardo Flores-Umanzor
Corresponding author
ejfu0209@gmail.com

Corresponding author:
, Pedro L. Cepas-Guillen, Xavier Freixa
Servicio de Cardiología, Instituto Cardiovascular, Hospital Clínic de Barcelona, Institut d’investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Universidad de Barcelona, Barcelona, Spain
This item has received
...
Visits
(Daily data update)
Article information
Full Text
Download PDF
Statistics
Figures (2)
Additional material (1)
Full Text

A 56-year-old man with infective endocarditis underwent mechanical prosthetic aortic valve implantation complicated by a large pseudoaneurysm of the left ventricular outflow tract (LVOT), which had been unsuccessfully treated by 2 previous surgical interventions. The patient was referred to our center for percutaneous closure of the pseudoaneurysm due to dyspnea and high surgical risk.

An echocardiogram demonstrated an LVOT pseudoaneurysm, and a computed tomography scan showed a mass of 10 × 8cm, connecting to the LVOT through a narrow 3-mm neck, adjacent to the anterior mitral valve. The mass was suggestive of a pseudoaneurysm (asterisk in Figure 1) based on contrast uptake in the late venous phase (Figure 1A and B [LV, left ventricle] and Video of the supplementary material).

Figure 1
(0.14MB).

A transseptal (TS) approach to the left ventricle through femoral venous access was used due to the presence of a mechanical aortic prosthetic valve, thereby avoiding a more invasive transapical access. A catheter was placed in the right atrium, and a TS puncture was performed with extreme caution due to the risk of pseudoaneurysm rupture because of its giant size. Initially, a deflectable Fustar 9-Fr system was placed; however, this system did not allow the catheter to be guided toward the entrance of the pseudoaneurysm, and so it was replaced with a Destination 6-Fr. The wire was introduced to the cavity, and with the aid of a diagnostic 4-Fr catheter, an Amplatzer Vascular Plug-4 was successfully deployed (Figure 2).

Figure 2
(0.07MB).

At a 6-month follow-up, the patient was asymptomatic, and a computed tomography scan and echocardiogram showed almost complete thrombosis of the pseudoaneurysm (Figure 1C and D; Ao, aorta).

Conflicts of interest

X. Freixa is proctor for St Jude Medical.

Copyright © 2018. Sociedad Española de Cardiología
Idiomas
Revista Española de Cardiología (English Edition)

Subscribe to our newsletter

Article options
Tools
Supplemental materials
es en

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

es en
Política de cookies Cookies policy
Utilizamos cookies propias y de terceros para mejorar nuestros servicios y mostrarle publicidad relacionada con sus preferencias mediante el análisis de sus hábitos de navegación. Si continua navegando, consideramos que acepta su uso. Puede cambiar la configuración u obtener más información aquí. To improve our services and products, we use "cookies" (own or third parties authorized) to show advertising related to client preferences through the analyses of navigation customer behavior. Continuing navigation will be considered as acceptance of this use. You can change the settings or obtain more information by clicking here.