Non-surgical management of post-Ross left ventricular pseudoaneurysm assisted by virtual reality imaging

Infective endocarditis (IE) can cause extensive cardiac tissue destruction, often requiring surgical reconstruction with pericardial patches. The compromised integrity of necrotic tissue increases the risk of pseudoaneurysm formation. Redo surgical repair of pseudoaneurysms is associated with high morbidity; thus, catheter-based interventions may be preferable in select cases. Percutaneous transapical access provides a direct route to left ventricular pseudoaneurysms but demands thorough preprocedural planning and intra-procedural imaging. We report the successful transapical device closure of a large left ventricular pseudoaneurysm following a Ross procedure for aortic valve IE.