Transcatheter Intervention for Complex Ascending Aortic Pseudoaneurysm After Cardiac Surgery

Yin, Wei Hsian; Wei, Jeng; Tsai, Shen Kou; Hsiung, Ming C.; Lee, Yung Tsai; Yu, Ho Ping; Ou, Ching Huei

doi:10.1253/circj.cj-14-0154

Cited by 11 publications

(13 citation statements)

References 13 publications

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“…In most patients, the current delivery systems for treating abdominal aortic aneurysms are too short to reach the ascending aorta from the femoral artery for ATAA repair. [2][3][4] In addition, the delivery systems for thoracic endovascular aortic repair (TEVAR) have large profiles and long nose cones that must be placed in the LV cavity, increasing the risk of LV perforation. No commercially available device is designed specifically for endovascular ATAA repair.…”

Section: Discussionmentioning

confidence: 99%

“…Results of several small studies have shown the feasibility of the endovascular approach for treating pathologic conditions of the ascending aorta. [2][3][4] Preventza and colleagues 2 used various devices off-label in 7 patients. At a median follow-up period of 14.4 months (range, 5.5-22.6 mo), the survival rate was 66.6% with no aorta-related deaths.…”

Section: Discussionmentioning

confidence: 99%

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Minimally Invasive Endovascular Repair of Ascending Thoracic Aortic Aneurysm with Use of Local Anesthesia and Conscious Sedation

Almanfi¹,

Krajcer²

2019

Texas Heart Institute Journal

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Ascending thoracic aortic aneurysm (ATAA) is typically treated surgically. No commercially available device has been specifically designed for endovascular ATAA repair, and currently, multiple anatomic and technical challenges affect its feasibility. Previously, such repairs have been performed with the patients under general anesthesia.We describe a novel, minimally invasive approach to endovascular repair of ATAA, involving local anesthesia, conscious sedation, and 24-hour hospitalization. Two consecutive male patients (ages, 79 and 54 yr) who had comorbidities underwent percutaneous transfemoral endovascular ATAA repair with use of commercially available endografts. Patient 1 had a saccular aneurysm, and Patient 2 had a pseudoaneurysm consequent to recent surgical ATAA repair. The patients were discharged from the hospital 24 hours after technically successful, uncomplicated procedures. At 2 months, computed tomograms showed no endoleak or stent-graft migration. Our experience shows that minimally invasive endovascular ATAA repair is feasible for selected high-risk patients. We describe the procedure, access and closure devices, and challenges associated with this approach. (Tex Heart Inst J 2019;46(2):120-3)

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Minimally Invasive Endovascular Repair of Ascending Thoracic Aortic Aneurysm with Use of Local Anesthesia and Conscious Sedation

Almanfi¹,

Krajcer²

2019

Texas Heart Institute Journal

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“…The particular location of the ascending aortic pseudoaneurysm directly affects the cardiac output, and the risk of complications, such as endoleaks, stent‐graft migration, myocardial infarction, and devise deployment failure, remains high. Yin et al reported three cases of ascending aortic pseudoaneurysm repair using Amplatzer. They discussed the difficulty of cannulating the guide wire into the pseudoaneurysms because of the postoperative tortuous ascending aorta.…”

Section: Discussionmentioning

confidence: 99%

Staged treatments of multiple pseudoaneurysms after total arch replacement

Kitada¹,

Okamura²,

Arakawa³

et al. 2019

J Card Surg

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Background: An aortic pseudoaneurysm after cardiovascular surgery can be fatal.Methods/Results: Here, we describe the staged successful treatments of three pseudoaneurysms in a 77-year-old female patient who underwent total arch replacement and coronary artery bypass grafting 5 years ago. Computed tomography revealed three pseudoaneurysms: in the distal anastomosis of the total arch replacement, in the anastomosis of the left common carotid artery, and in the proximal anastomosis of the saphenous vein graft. Endovascular treatment and surgical repair were performed to treat these three pseudoaneurysms.Discussion: An aortic pseudoaneurysm is a rare complication after cardiac or aortic surgery. Here, we present a case of combined endovascular and surgical repairs of three pseudoaneurysms in one patient. K E Y W O R D Saorta and great vessels

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“…Therefore, surgical repair has been generally considered as the treatment of choice regardless of the presence of symptoms; however, sometimes it can be challenging with reported mortality rates ranging from 6.7% to 29% [ 3 4 9 ]. In the last decade, percutaneous endovascular closure of PsA was developed as a less invasive alternative treatment for high surgical risk patients [ 7 10 ]. The treatment option of endovascular approach has been reported including intra-arterial thrombin injection, coil embolization, aortic stent graft insertion and closure using an Amplatzer septal occluder device.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the relatively improved outcomes, open surgical treatment is challenging and the morbidity and mortality rates of PsA are still high [ 3 4 ]. Furthermore, surgical treatment of PsA located in the aorta or the left ventricular outflow tract (LVOT) can cause serious complications, such as aorto-mitral valve disruption or coronary compromise [ 5 6 7 ].…”

mentioning

confidence: 99%

Transesophageal echocardiographic guidance for percutaneous closure of aortic pseudoaneurysm using a type II Amplatzer vascular plug: a case report

Kim

Lee

Sung

et al. 2016

Korean J Anesthesiol

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Aortic pseudoaneurysm after cardiac surgery is a rare entity, but it is potentially fatal due to its clinical course along with higher morbidity and mortality rates. Instead of open surgical repair, percutaneous procedures have been introduced as other options for managing an aortic pseudoaneurysm. In this case report, we describe transesophageal echocardiography guidance for successful percutaneous closure of an aortic pseudoaneurysm located in the left ventricular outflow tract by using a type II Amplatzer vascular plug in a patient in whom open surgical repair was not recommended.

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Transcatheter Intervention for Complex Ascending Aortic Pseudoaneurysm After Cardiac Surgery

Cited by 11 publications

References 13 publications

Minimally Invasive Endovascular Repair of Ascending Thoracic Aortic Aneurysm with Use of Local Anesthesia and Conscious Sedation

Minimally Invasive Endovascular Repair of Ascending Thoracic Aortic Aneurysm with Use of Local Anesthesia and Conscious Sedation

Staged treatments of multiple pseudoaneurysms after total arch replacement

Transesophageal echocardiographic guidance for percutaneous closure of aortic pseudoaneurysm using a type II Amplatzer vascular plug: a case report

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