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Percutaneous Closure of Postinfarct Left Ventricular Pseudoaneurysm After Surgical Patch Dehiscence
Bryan P Traynor1, Syed M Ali Hassan2, Thomas Attumalil1
1Structural Heart Program, St Michael's Hospital, University of Toronto, Toronto, Ontario, Canada.
Background:
Left ventricular free wall rupture is a life-threatening mechanical complication of ST-segment elevation myocardial infarction. In patients with a timely diagnosis, emergent surgical patch repair is the cornerstone of management; re-rupture, surgical patch dehiscence, and left ventricular pseudoaneurysm (LVPA) are potential late complications after surgery.
Case Summary:
A 72-year-old man presented with NYHA functional class III dyspnea 4 months after surgical patch repair. We report, to our knowledge, the first case of successful percutaneous closure of LVPA resulting from surgical patch dehiscence.
Discussion:
LVPA after surgical repair is a serious late complication. Multimodality imaging and careful case planning allowed for successful device closure with excellent clinical outcome.
Take-Home Messages:
Multimodality cardiac imaging is essential for accurate diagnosis and management of acute left ventricular free wall rupture and LVPA resulting from surgical patch dehiscence. Percutaneous closure of LVPA after surgical patch dehiscence is an effective and safe alternative to redo surgery.
