Related Experiment Video
Updated: May 16, 2026
Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
Published on: May 26, 2023
Successful Sealing of Steam Pop-Related Left Ventricular Summit Perforation With Partial Impella Support
Hiroyuki Miyazawa1, Yasuya Inden1, Masafumi Shimojo1
1Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Background:
Impella is effective for left ventricular (LV) rupture after myocardial infarction. However, its role in managing LV perforation during catheter ablation in structurally normal hearts, particularly at the LV summit, remains unclear.
Case Summary:
A 69-year-old woman developed LV perforation due to a steam pop during ablation for premature ventricular contractions. After emergency surgery, the pseudoaneurysm persisted despite intra-aortic balloon pump (IABP) support and multifactorial management. The IABP was then replaced with Impella CP, and the pseudoaneurysm later closed spontaneously. The patient recovered without sequelae.
Discussion:
LV summit perforation caused by steam pops is challenging to manage because of the anatomical complexity and tissue fragility. Although the favorable outcome was likely multifactorial, Impella support may still have contributed to the overall management strategy despite the small, nondilated LV and support being limited to performance level 2 (P2).
Take-Home Message:
Pseudoaneurysm after LV perforation may be managed with multifactorial therapy, including partial Impella support.
