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Published on: February 26, 2013
Coil embolization of left ventricular outflow tract pseudoaneurysms: techniques and 5-year results
Hideki Ota1, Yoshiaki Morita1,2, Yoshikatsu Saiki3
1Department of Diagnostic Radiology, Tohoku University Hospital, Sendai, Japan.
Insights
Percutaneous coil embolization effectively treated left ventricular outflow tract (LVOT) pseudoaneurysms in patients with complex surgical histories. This minimally invasive approach showed no complications and no recurrence over five years.
Area of Science:
- Cardiovascular Surgery
- Interventional Cardiology
- Medical Imaging
Background:
- Left ventricular outflow tract (LVOT) pseudoaneurysms are rare but serious complications, often associated with prior aortic root surgery or inflammatory conditions.
- These pseudoaneurysms pose a significant risk of rupture and hemodynamic compromise, necessitating effective treatment strategies.
Observation:
- Computed tomography (CT) imaging was crucial in diagnosing and characterizing the pseudoaneurysms, revealing their connection to the LVOT lumen.
- A transfemoral approach allowed for the precise placement of a 6-Fr catheter into the pseudoaneurysm sac.
Findings:
- Percutaneous coil embolization was successfully performed in three patients with LVOT pseudoaneurysms.
- A 0.052-inch coil was deployed across the fistulous tract, occluding the pseudoaneurysm.
- The procedure was associated with no significant complications during or after treatment.
Implications:
- Coil embolization represents a potentially effective and minimally invasive treatment option for LVOT pseudoaneurysms, particularly in high-risk patients.
- The technique demonstrated durable results, with no recurrence observed during a 5-year follow-up period.
- This approach may offer a valuable alternative to open surgical repair for selected patients with complex aortic root histories.
Abstract:
We present 3 cases of percutaneous coil embolization of left ventricular outflow tract (LVOT) pseudoaneurysms. All patients had a history of repetitive aortic root surgery and/or inflammatory disease. Computed tomography showed pseudoaneurysms connecting the sacs to the LVOT lumen. In each case, a 6-Fr catheter was advanced to the sac by the transfemoral approach. A 0.052-in coil was placed across the tract. There was no significant complications associated with the procedure. No recurrence was evident in any case during the 5-year follow-up. Coil embolization may be an effective treatment for these pseudoaneurysms in patients with complicated histories of aortic root surgery.
