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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Left Ventricular Pseudoaneurysm Possibly Associated with Rivaroxaban Therapy Disappeared after Cessation of
Kentaro Kiryu1, Gembu Yamaura1, Daichi Takagi1
1Department of Cardiovascular Surgery, Akita University Graduate School of Medicine, Akita, Akita, Japan.
Introduction:
Although iatrogenic left ventricular pseudoaneurysm (LVPA) is rare, its treatment strategy needs consideration. We report a case in which postoperative initiation of rivaroxavan led to iatrogenic LVPA, which resolved spontaneously after drug cessation.
Case Presentation:
A 69-year-old man was diagnosed with a 76-mm saccular aortic arch aneurysm. He underwent urgent total aortic arch replacement with a frozen elephant trunk. A left ventricular apex injury due to intraoperative vent insertion was repaired, and postoperative CT revealed no problems. While hospitalized, he developed atrial fibrillation and started taking rivaroxavan. At 3 months postoperatively, an LVPA, 10 mm in diameter, developed at the intraoperative repair site. The LVPA resolved spontaneously following discontinuation of rivaroxaban, thereby avoiding the need for reoperation.
Conclusions:
This case illustrates the potential for anticoagulation-associated LVPA formation in surgically repaired myocardium and supports the consideration of conservative management in selected cases.
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