Sealing the Leak

Left ventricular pseudoaneurysm (LVPA) is a rare but potentially life-threatening complication. Although surgical repair remains the gold standard, percutaneous closure has emerged as a less invasive and feasible option for high-risk surgical candidates. We present the case of a 76-year-old woman with 2 prior sternotomies for mitral valve repair and subsequent replacement, who presented with worsening dyspnea on exertion. A computed tomography scan performed to rule out pulmonary embolism led to the incidental discovery of an LVPA. We describe a percutaneous approach using multimodal imaging guidance for successful coiling and closure of the LVPA with an Amplatzer ventricular septal defect occluder device.