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Updated: Jun 15, 2026
12:43
Rodent Working Heart Model for the Study of Myocardial Performance and Oxygen Consumption
Published on: August 16, 2016
A hole in the heart
Dariusch Haghi1, Tim Suselbeck, Theano Papavassiliu
1First Department of Medicine, University Hospital Mannheim, Mannheim, Germany.
Summary
A stiff guidewire caused a left ventricular (LV) apex perforation during aortic valve replacement. Three-dimensional echocardiography clearly visualized the LV rupture, aiding in assessment.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Echocardiography
Background:
- Percutaneous aortic valve replacement (TAVR) is a common procedure for aortic stenosis.
- Complications, though rare, can occur, necessitating advanced imaging for diagnosis and management.
- Guidewire manipulation is a critical step in TAVR procedures.
Observation:
- A 91-year-old male undergoing TAVR experienced a left ventricular (LV) apex perforation due to an overly stiff guidewire.
- Initial two-dimensional echocardiography identified a perforation and pseudoaneurysm but lacked precise detail.
- Three-dimensional echocardiography was employed to better characterize the injury.
Findings:
- Three-dimensional echocardiography successfully visualized an oval-shaped perforation at the LV apex, measuring approximately 0.8 cm².
- This advanced imaging modality provided superior anatomical detail compared to 2D echocardiography.
- The geometry and potential flow dynamics across the rupture site were clearly depicted.
Implications:
- This case highlights the critical role of advanced echocardiography, specifically 3D imaging, in diagnosing and assessing complex cardiac injuries.
- Three-dimensional echocardiography offers unique value in visualizing the precise geometry and flow characteristics of left ventricular rupture sites.
- Enhanced visualization aids in guiding subsequent management strategies for procedural complications.
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