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• W3092802025 abstract "SESSION TITLE: Fellows Cardiovascular Disease Posters SESSION TYPE: Fellow Case Report Posters PRESENTED ON: October 18-21, 2020 INTRODUCTION: A ventricular aneurysm is a defect in the ventricle of the heart, usually produced by transmural infarction. In the heart, they usually arise from a patch of weakened tissue in a ventricular wall. Ventricular aneurysms can lead to complications and even death. CASE PRESENTATION: An 86-year-old female underwent transapical transcatheter aortic valve replacement (TAVR) for critical aortic stenosis. On post-operative day 2, transthoracic echocardiogram (TTE) findings demonstrated a anechoic loculated collection measuring 3.1x4.5cm in apical region suggestive of pseudoanuerysm confirmed by color Doppler imaging (Figure 1: A & B). 3D computed tomography revealed a pseudoaneurysm along the distal anterior wall measuring 5.19cm x 2.98cm x 6.2cm (Figure 1: C). The patient subsequently underwent pseudoaneurysm closure with a 10mm ventricular septal defect (VSD) closure device via amplatz delivery sheath with minimal extravasation of contrast into aneurysmal sac (Figure 2). Follow up transthoracic echocardiogram with color Doppler confirmed successful placement of VSD closure device without evidence of color flow across the device (Figure 3). Patient was evaluated three months later at routine outpatient follow up by TTE without interval change and marked improvement of symptoms. DISCUSSION: Left ventricular pseudoaneurysm is commonly associated with complications following myocardial infarction, surgical valve replacement, thoracic aortic surgery and endocarditis. Pseudoaneurysm following TAVR has a reported incidence rate of less than 1%. Coil embolization and septal occlusion devices provide the safest therapeutic option. To this date, 11 reported cases involving percutaneous closure of left ventricular pseudoaneurysm exist. CONCLUSIONS: Our case depicts the feasibility of successful percutaneous intervention of a left ventricular pseudoaneurysm under conscious sedation with fluoroscopic and TTE guidance. Reference #1: Clift, P., Thorne, S., & De Giovanni, J. (2004). Percutaneous device closure of a pseudoaneurysm of the left ventricular wall. Heart, 90(10), e62-e62. Reference #2: Kumar, P. V., Alli, O., Bjarnason, H., Hagler, D. J., Sundt, T. M., & Rihal, C. S. (2012). Percutaneous therapeutic approaches to closure of cardiac pseudoaneurysms. Catheterization and Cardiovascular Interventions, 80(4), 687-699. Reference #3: Zoffoli G, Mangino D, Venturini A, et al. (February 2009). Diagnosing left ventricular aneurysm from pseudo-aneurysm: a case report and a review in literature. J Cardiothorac Surg. DISCLOSURES: No relevant relationships by Sebastian Carrasquillo, source=Web Response No relevant relationships by Maedeh Ganji, source=Web Response No relevant relationships by Jose Ruiz-Morales, source=Web Response No relevant relationships by Daniel Soffer, source=Web Response" @default.
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• W3092802025 date "2020-10-01" @default.
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• W3092802025 title "INSIDE OUT: LEFT VENTRICULAR ANEURYSM FOLLOWING TRANSCATHETER AORTIC VALVE REPLACEMENT" @default.
• W3092802025 doi "https://doi.org/10.1016/j.chest.2020.08.164" @default.
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