Key result
Hybrid off-pump transapical approach successfully treats pseudoaneurysm and PVL in a high-risk patient.
Case Report (n=1)
A hybrid off-pump transapical approach can be successfully used for simultaneous treatment of a ventricular pseudoaneurysm, mitral paravalvular leak, and complete AV block in high-risk patients.
May support hybrid off-pump transapical repair in select high-risk cases; hypothesis-generating and requires prospective validation.
We present the case of a 74-year-old male with a medical history of hypertension, type 2 diabetes, and dyslipidemia, who had previously undergone two cardiac surgeries: the first for coronary artery disease and severe mitral regurgitation, and the second for mitro-aortic endocarditis. The patient developed a large inferolateral ventricular pseudoaneurysm, an anterolateral mitral paravalvular leak with moderate mitral regurgitation, and a complete atrioventricular block. Given the high risk associated with a third conventional open-heart surgery, a hybrid off-pump transapical approach was proposed. The patient was successfully treated with coil closure of the pseudoaneurysm, repair of the paravalvular leak using an Amplatzer device, and implantation of definitive epicardial electrodes via a transapical approach, with complete procedural success.
No takes yet. Share an insight, caveat, or question.
Marco et al. (2025) conducted a case report in Ventricular pseudoaneurysm and mitral paravalvular leak (n=1). Hybrid off-pump transapical approach (coil closure, Amplatzer device, epicardial electrodes) was evaluated on Procedural success. A hybrid off-pump transapical approach achieved complete procedural success for coil closure of a pseudoaneurysm, paravalvular leak repair, and epicardial electrode implantation in a high-risk patient.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: