Percutaneous closure of left ventricular pseudoaneurysm in a patient with concomitant true left ventricular aneurysm.

Affiliation

Cavalcanti LRP(1)(2), Sá MPBO(1)(2)(3), Escorel Neto AC(1)(2), Holz BS(4), Nunes Filho EO(1)(2), Gaia DF(5), Soares AMMN(1)(2), Lima RC(1)(2)(3).
Author information:
(1)Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.
(2)University of Pernambuco-UPE, Recife, Brazil.
(3)Nucleus of Postgraduate and Research in Health Sciences, Faculty of Medical Sciences and Biological Sciences Institute-FCM/ICB, Recife, Brazil.
(4)Division of Cardiovascular Surgery, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, Brazil.
(5)Escola Paulista de Medicina, Division of Cardiovascular Surgery, Federal University of São Paulo, São Paulo, Brazil.

Abstract

BACKGROUND: Left ventricular aneurysms (LVA) are serious complications of myocardial infarction, being divided into true and false type. The false one-pseudoaneurysm (PA), is a life-threatening condition that requires urgent treatment due to the high risk of rupture. CASE PRESENTATION: An 84-year-old female presented with progressive heart failure symptoms. Investigation showed a small true LVA and a large PA. Open surgical repair was ruled out as Euroscore and Society of Thoracic Surgeons (STS) score were 42.80% and 39.97%, respectively. After discussion at our Heart Team meeting, percutaneous approach was found to be the best option. Guided by transesophageal echocardiography, we used an interventricular septal defect occluder to close the gap between the LV and the PA. Control ventriculography showed full closure of the gap, with no residual flow to the PA cavity. The patient was discharged from the hospital on the fifth postoperative day and has remained asymptomatic since then. CONCLUSION: Percutaneous approach proved to be a safe and effective modality to treat LV PA. The device implanted achieved the goal of blocking blood flow through the communication between LV and the PA.