Percutaneous closure of left ventricular pseudoaneurysm

Circ Cardiovasc Interv. 2011 Aug;4(4):322-6. doi: 10.1161/CIRCINTERVENTIONS.111.962464. Epub 2011 Jul 26.

Abstract

Background: 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.

Methods and results: 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.

Conclusions: 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.

MeSH terms

  • Administration, Cutaneous
  • Aged
  • Aged, 80 and over
  • Aneurysm, False / diagnosis
  • Aneurysm, False / etiology
  • Aneurysm, False / physiopathology
  • Aneurysm, False / surgery*
  • Cardiac Catheterization*
  • Diagnostic Imaging
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / surgery*
  • Postoperative Complications*
  • Retrospective Studies
  • Ventricular Dysfunction, Left / diagnosis
  • Ventricular Dysfunction, Left / etiology
  • Ventricular Dysfunction, Left / physiopathology
  • Ventricular Dysfunction, Left / surgery*
  • Wound Closure Techniques*