European Journal of Cardio-Thoracic Surgery 48 (2015) 172–173 doi:10.1093/ejcts/ezu353 Advance Access publication 14 October 2014
IMAGES IN CARDIO-THORACIC SURGERY
Cite this article as: Noack T, Kiefer P, Mohr F-W, Holzhey DM. Late left ventricular pseudoaneurysm following transfemoral transcatheter aortic valve replacement. Eur J Cardiothorac Surg 2015;48:172–3.
Late left ventricular pseudoaneurysm following transfemoral transcatheter aortic valve replacement Thilo Noack*, Philipp Kiefer, Friedrich-Wilhelm Mohr and David Michael Holzhey Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany * Corresponding author. Department of Cardiac Surgery, Heart Center Leipzig University, Struempellstrasse 39, 04289 Leipzig, Germany. Tel: +49-341-8651452; fax: +49-341-8651421; e-mail: [email protected] (T. Noack). Received 20 June 2014; received in revised form 25 July 2014; accepted 1 August 2014
Keywords: Left ventricular aneurysm • Transfemoral transcatheter aortic valve replacement
A 79-year old woman, with a transfemoral transcatheter aortic valve replacement (TAVR) using a 29-mm CoreValve® prosthesis 12 months before, shows on echocardiographic follow-up a new left ventricular (LV) apical pseudoaneurysm (Fig. 1A and B; Videos
1 and 2). We hypothesize, however, micro-injury of the LV apex endothelium with subsequent myocardial infiltration caused by the super-stiff wire used during transfemoral TAVR. Surgical aneurysm resection represents the successful treatment (Fig. 1C).
Figure 1: Initial transthoracic echocardiography revealed a perfused cavity (A1 and A2) and CT scan showed an left ventricular (LV) apical pseudoaneurysm (B1 and B2). Operative findings show the opened pseudoaneurysm and closure of LV perforation with felt-pledgeted sutures after resection of the pseudoaneurysm (C1 and C2). CT: computed tomography.
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
T. Noack et al. / European Journal of Cardio-Thoracic Surgery
Video 2: Computed tomography showed an left ventricular apical pseudoaneurysm.
IMAGES IN CARDIOTHORACIC SURGERY
Video 1: Initial transthoracic echocardiography revealed an apical perfused cavity.
173
IMAGES IN CARDIO-THORACIC SURGERY
Cite this article as: Noack T, Kiefer P, Mohr F-W, Holzhey DM. Late left ventricular pseudoaneurysm following transfemoral transcatheter aortic valve replacement. Eur J Cardiothorac Surg 2015;48:172–3.
Late left ventricular pseudoaneurysm following transfemoral transcatheter aortic valve replacement Thilo Noack*, Philipp Kiefer, Friedrich-Wilhelm Mohr and David Michael Holzhey Department of Cardiac Surgery, Heart Center Leipzig University, Leipzig, Germany * Corresponding author. Department of Cardiac Surgery, Heart Center Leipzig University, Struempellstrasse 39, 04289 Leipzig, Germany. Tel: +49-341-8651452; fax: +49-341-8651421; e-mail: [email protected] (T. Noack). Received 20 June 2014; received in revised form 25 July 2014; accepted 1 August 2014
Keywords: Left ventricular aneurysm • Transfemoral transcatheter aortic valve replacement
A 79-year old woman, with a transfemoral transcatheter aortic valve replacement (TAVR) using a 29-mm CoreValve® prosthesis 12 months before, shows on echocardiographic follow-up a new left ventricular (LV) apical pseudoaneurysm (Fig. 1A and B; Videos
1 and 2). We hypothesize, however, micro-injury of the LV apex endothelium with subsequent myocardial infiltration caused by the super-stiff wire used during transfemoral TAVR. Surgical aneurysm resection represents the successful treatment (Fig. 1C).
Figure 1: Initial transthoracic echocardiography revealed a perfused cavity (A1 and A2) and CT scan showed an left ventricular (LV) apical pseudoaneurysm (B1 and B2). Operative findings show the opened pseudoaneurysm and closure of LV perforation with felt-pledgeted sutures after resection of the pseudoaneurysm (C1 and C2). CT: computed tomography.
© The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.
T. Noack et al. / European Journal of Cardio-Thoracic Surgery
Video 2: Computed tomography showed an left ventricular apical pseudoaneurysm.
IMAGES IN CARDIOTHORACIC SURGERY
Video 1: Initial transthoracic echocardiography revealed an apical perfused cavity.
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