title: Percutaneous closure of a left ventricular pseudoaneurysm in a high-risk surgical candidate.
abstract: Few cases of percutaneous device closure of a left ventricular pseudoaneurysm have been reported. We describe the case of a 67-year-old man with a history of coronary artery disease who presented with shortness of breath and chest pain. Computed tomographic angiography showed a left ventricular pseudoaneurysm that was filling from a small leak in the anterolateral aspect of the ventricle. The patient had undergone 3 previous sternotomies and was a high-risk candidate for surgical treatment of the pseudoaneurysm. Despite technical challenges, we closed the pseudoaneurysm percutaneously with use of a 6-mm AMPLATZER muscular ventricular septal defect occluder. The patient was released from the hospital the next day and was asymptomatic a year later.To our knowledge, this is the first report of the percutaneous closure of a left ventricular pseudoaneurysm via the femoral vein. We show that this manner of closure can be feasible in patients who have undergone multiple sternotomies and who are at high surgical risk.
authors.affiliation: Department of Adult Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA. biswajit.kar@uth.tmc.edu
authors.forename: Biswajit
authors.initials: B
authors.lastname: Kar
authors.forename: Gunjan
authors.initials: G
authors.lastname: Gholkar
authors.forename: Igor D
authors.initials: ID
authors.lastname: Gregoric
authors.forename: Surendra K
authors.initials: SK
authors.lastname: Jain
authors.forename: Pranav
authors.initials: P
authors.lastname: Loyalka
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000628:therapy*; D006328:Cardiac Catheterization / Q000295:instrumentation; D017023:Coronary Angiography / Q000379:methods; D005268:Femoral Vein / Q000000981:diagnostic imaging; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000628:therapy*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D011474:Prosthesis Design; D055989:Septal Occluder Device; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
keywords: Aneurysm, false/complications/therapy; heart catheterization/instrumentation; heart ventricles; risk factors; septal occluder device; surgical procedures, minimally invasive; treatment outcome; ventricular dysfunction, left/complications/therapy