Direct percutaneous transaortic approach for treatment of aortic pseudoaneurysms

Publication Date

2015

Journal Title

Interact Cardiovasc Thorac Surg

Abstract

Aortic pseudoaneurysms (APAs) can develop months or years after aortic and cardiac surgery. If not treated appropriately, APAs can lead to fatal complications and ultimately death. We describe a case of a 61-year old patient with a diagnosed large pseudoaneurysm 5 years after his aortic valve surgery, who was treated with a novel transcatheter direct transaortic approach. The patient had dilated cardiomyopathy with an APA adjacent to the lower sternal plate. An Amplatzer septal occlusion device followed by coils was delivered transcutaneously through the APA to close its neck and fill the false aneurysm, respectively. Triple fusion multimodality imaging was used to guide the placement of the occlusion devices. The merging of computed tomography (CT) and echocardiography with real-time fluoroscopy was fundamental in procedural planning and guidance. Post-procedural transoesophageal echocardiogram (TOE) and CT angiography showed complete exclusion of the APA. A direct transaortic approach is a valid option for closure of an APA if the surgical risk is prohibitive, and the use of triple fusion technology is an essential tool in the hands of interventionalists and surgeons for preoperative planning and conduction of these procedures.

Volume Number

20

Issue Number

5

Pages

680-681

Document Type

Article

EPub Date

2015/02/26

Status

Faculty, Northwell Researcher

Facility

School of Medicine; Northwell Health

Primary Department

Cardiology

Additional Departments

Pediatrics; Cardiovascular and Thoracic Surgery

PMID

25712986

DOI

10.1093/icvts/ivv027

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