Percutaneous closure of left ventricular pseudoaneurysm

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Left ventricular pseudoaneurysm (LVPA) is a rare but severe complication following myocardial infarction or cardiac surgery.
• Surgical intervention is the standard treatment, but percutaneous closure is emerging for high-risk patients.
• Existing literature on percutaneous LVPA treatment consists mainly of single case reports.

Purpose of the Study:

• To evaluate the feasibility and outcomes of percutaneous closure for left ventricular pseudoaneurysms.
• To present the first series of percutaneous treatments for LVPA.

Main Methods:

• Retrospective analysis of 9 procedures in 7 consecutive patients (ages 51-83) undergoing percutaneous LVPA repair.
• Patients were selected due to high surgical risk from comorbidities.
• Multiple imaging modalities were utilized for pre-procedural planning, intra-procedural guidance, and post-procedural assessment.

Main Results:

• Successful percutaneous repair of left ventricular pseudoaneurysms in all 7 patients.
• Average fluoroscopy time was 36.5±24.0 minutes.
• Follow-up (3-32 months) showed significant functional improvement, with all patients improving by at least one NYHA class and 4 improving by two classes.

Conclusions:

• Transcatheter closure of left ventricular pseudoaneurysm is a viable alternative for patients unsuitable for surgery.
• Comprehensive imaging is crucial for successful planning and execution of these complex procedures.