Dataset Information

Emergent percutaneous closure of sub-annular aortic root pseudoaneurysm in the setting of composite graft dehiscence: a case report.

ABSTRACT:

Background

Aortic conduit pseudoaneurysms are rare complications of surgical aortic root replacements. These complications are typically treated with a redo-sternotomy, but these surgeries carry high mortality rates, and patients may not always be good surgical candidates. There have been a few reported cases where aortic pseudoaneurysms have been successfully treated percutaneously with both short- and long-term success. We describe a case were a sub-annular aortic root pseudoaneurysm was closed using an Amplatzer Vascular Plug 2 device.

Case summary

A 68-year-old man was admitted to the hospital 6 weeks after surgical aortic valve and aortic root replacement undergone for prosthetic valve endocarditis. On computed tomography, he was found to have a large fluid collection with extravasation into a false lumen located on the right side of the ascending aorta. Diagnostic catheterization confirmed flow into the pseudoaneurysm cavity from a sub-annular location. This defect was then closed using an Amplatzer Vascular Plug 2 device, with no residual flow or concern for re-opening at 8 months follow-up.

Discussion

This case presents the first documented use of an Amplatzer Vascular Plug 2 to close an aortic root pseudoaneurysm in the sub-annular location. Heart team discussion is crucial in determining whether surgical or percutaneous treatment management should be performed. This case highlights a novel treatment method for sub-annular aortic root pseudoaneurysms which can be considered an alternative to surgery and potentially life-saving for high-risk patients.

SUBMITTER: Stephenson S

PROVIDER: S-EPMC10716677 | biostudies-literature | 2023 Dec

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Emergent percutaneous closure of sub-annular aortic root pseudoaneurysm in the setting of composite graft dehiscence: a case report.

Stephenson Samuel S Gambill Michael M Summers Matthew M

European heart journal. Case reports 20231130 12

<h4>Background</h4>Aortic conduit pseudoaneurysms are rare complications of surgical aortic root replacements. These complications are typically treated with a redo-sternotomy, but these surgeries carry high mortality rates, and patients may not always be good surgical candidates. There have been a few reported cases where aortic pseudoaneurysms have been successfully treated percutaneously with both short- and long-term success. We describe a case were a sub-annular aortic root pseudoaneurysm w ...[more]

PMID: 38093824

Similar Datasets

Project description:BackgroundPercutaneous closure of residual ventricular septal defects (VSDs) after congenital heart surgery may provide a safer and more efficient alternative to redo surgery. This study aimed to evaluate the outcome of transcatheter closure of residual postoperative VSD.MethodsThis multicenter retrospective cohort study was conducted at the tertiary care institutions of King Faisal Specialist Hospital and King Abdulaziz University Hospital, Saudi Arabia, from March 2012 to March 2022. All patients who underwent transcatheter closure of postoperative residual VSD were included. As catheter closure of VSD related to surgical patches is challenging, patients were divided into two groups. Group 1 comprised patients with VSD related to the surgical patches, while Group 2 included residual muscular VSD. Various occluders and approaches were utilized based on the patient's weight and the VSD type, size, and proximity to the cardiac valves. Demographic, echocardiographic, catheterization, and outcome data were collected and analyzed using descriptive and comparative statistics.ResultsThirty-three patients underwent 37 VSD catheter closure procedures. Twenty-two procedures were done to close residual VSD related to the surgical patch, while fifteen were done for additional muscular VSD. The median age of the patients was 3.3 years, and the interquartile range (IQR) ranged between 9 months and 7 years. The median weight was 13.1 kilograms, with an IQR of 5.1 to 16.8 kilograms. The median pulmonary to systemic flow ratio (QP/QS) was 1.6 with an IQR of 1.5 to 2.44; the median systolic pulmonary pressure was 46 mmHg with an IQR of 32 to 54 mmHg. The median procedure duration was 120 minutes, with an IQR of 90 to 160 minutes. Patients in Group 1 were older and had a lower mean pulmonary pressure than Group 2 (P=0.02, P=0.007, respectively). Of the 37 procedures, 35 (94.6%) were done successfully, while two patients had redo surgery due to failed procedures (one had device embolization). Ten successful catheterizations were performed for infants weighing ≤5 kilograms. The functional heart failure class improved significantly after the closure of the residual VSD. There were three documented mortalities, none related to the procedure. No significant difference between patient groups regarding hospital stay or survival (P=0.660, P=0.791, respectively).ConclusionsAfter congenital heart surgery, transcatheter closure of residual VSD may be a safe and effective alternative to surgical closure. It can be applied to various residual VSD using a variety of occluders with satisfactory results. Moreover, using specific approaches can close residual VSD, even in small infants.

Dataset Information

Emergent percutaneous closure of sub-annular aortic root pseudoaneurysm in the setting of composite graft dehiscence: a case report.

Background

Case summary

Discussion

Publications

Emergent percutaneous closure of sub-annular aortic root pseudoaneurysm in the setting of composite graft dehiscence: a case report.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets