Pseudoaneurysm Repair With a Septal Occluder

Area of Science:

• Cardiovascular Surgery
• Interventional Cardiology
• Vascular Medicine

Background:

• Acute type A aortic dissection repair, while improved by endovascular techniques, carries a risk of late anastomotic pseudoaneurysms.
• These pseudoaneurysms can lead to serious complications and re-operation via re-sternotomy poses high risks.
• A significant unmet need exists for less invasive therapeutic options for pseudoaneurysms.

Observation:

• A 59-year-old male, previously treated for type A aortic dissection, presented with two pseudoaneurysms.
• One symptomatic pseudoaneurysm was at the celiac trunk, and an asymptomatic one was at the aortic arch graft anastomosis.
• Due to high surgical risk from comorbidities, percutaneous treatment was chosen.

Findings:

• The symptomatic pseudoaneurysm was treated with a covered stent.
• The asymptomatic pseudoaneurysm was successfully treated using an Amplatzer septal occluder.
• Three-month follow-up CT confirmed successful exclusion of the pseudoaneurysms.

Implications:

• Percutaneous treatment of aortic pseudoaneurysms, including using septal occluders, is a viable alternative to open surgery.
• This approach offers a lower morbidity and mortality option for high-risk patients.
• Further research into percutaneous techniques can expand treatment options for aortic complications.