Key result
Percutaneous VSD occluder successfully closes an LV pseudoaneurysm in a high-surgical-risk patient.
Why the study?
Left ventricular pseudoaneurysms are life-threatening complications of myocardial infarction requiring urgent treatment due to high rupture risk.
Case Report (n=1)
Percutaneous closure using an interventricular septal defect occluder may be a safe and effective alternative to surgery for high-risk patients with left ventricular pseudoaneurysms.
May support percutaneous closure for select high-risk LV pseudoaneurysms; hypothesis-generating and should not yet change practice.
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.
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Cavalcanti et al. (2021) conducted a case report in Left ventricular pseudoaneurysm (n=1). Percutaneous closure using an interventricular septal defect occluder was evaluated on Closure of the gap between the LV and the PA. Percutaneous closure using an interventricular septal defect occluder successfully achieved full closure of a left ventricular pseudoaneurysm in a high-surgical-risk patient.
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