title: Minimally Invasive Repair of Left Ventricular Pseudoaneurysm after Transapical Transcatheter Aortic Valve Replacement.
abstract: Transcatheter aortic valve replacement is becoming a routine procedure to treat severe symptomatic aortic stenosis. At most transcatheter aortic valve replacement centers, transapical access is a frequent alternative for use in patients whose ileofemoral access is inadequate. Transapical access is increasingly applied to a variety of other structural heart and aortic procedures as well. There is a caveat, however. When performed in elderly patients with friable myocardium, transapical access is associated with such serious sequelae as bleeding and left ventricular apical pseudoaneurysmal formation. Here, we describe the case of a 70-year-old woman who developed a left ventricular apical pseudoaneurysm 3 weeks after transapical transcatheter aortic valve replacement. Our successful repair took a minimally invasive left lateral approach that involved peripheral cardiopulmonary bypass cannulation, Foley catheter occlusion and primary defect closure, and BioGlue reinforcement.
authors.forename: Basel
authors.initials: B
authors.lastname: Ramlawi
authors.forename: Walid K
authors.initials: WK
authors.lastname: Abu Saleh
authors.forename: Odeaa
authors.initials: O
authors.lastname: Al Jabbari
authors.forename: Colin M
authors.initials: CM
authors.lastname: Barker
authors.forename: Neal S
authors.initials: NS
authors.lastname: Kleiman
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Reardon
mesh_terms: D000368:Aged; D017541:Aneurysm, False / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006348:Cardiac Surgical Procedures / Q000379:methods; D005260:Female; D006322:Heart Aneurysm / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D006801:Humans; D019028:Magnetic Resonance Imaging, Cine; D019060:Minimally Invasive Surgical Procedures / Q000379:methods*; D011183:Postoperative Complications; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D065467:Transcatheter Aortic Valve Replacement / Q000009:adverse effects*
keywords: Left ventricular apex; TAVR, transapical; minimally invasive surgical procedures/methods; postoperative complications; pseudoaneurysm