Percutaneous Closure of a Left Ventricular Pseudoaneurysm Causing Recurrent Embolization, With Cerebral Protection and Extracorporeal Membrane Oxygenation Support

Pavani, Marco; Scrocca, Innocenzo; Meliga, Emanuele; Benedictis, Mauro De

doi:10.1016/j.jcin.2017.09.018

Cited by 6 publications

(8 citation statements)

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“…The search strategy revealed 3,051 unique articles that underwent title and abstract review, which led to 2,905 studies being excluded. Of the remaining 146 studies, 15 studies were included in the qualitative synthesis of the percutaneous management of PMR (7-21), 4 were included in the qualitative analysis of the percutaneous management of LV FWR (22)(23)(24)(25), 7 studies defined the outcomes of the percutaneous management of LV pseudoaneurysm (15,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41) and 25 were included in the quantitative metaanalysis of the primary percutaneous management of post-MI VSD (42-66) (Table 1) (Figure S1).…”

Section: Resultsmentioning

confidence: 99%

“…Seventeen studies described techniques for ventricular pseudoaneurysm management, including 19 patients with an age range of 47-85 (15,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37)(38)(39)(40)(41). Two patients presented with cardiogenic shock (15,39), eight with dyspnoea (15,26,28,31,33,34,38,40) and one required mechanical circulatory support (39).…”

Section: Ventricular Pseudoaneurysmmentioning

confidence: 99%

“…Two patients presented with cardiogenic shock (15,39), eight with dyspnoea (15,26,28,31,33,34,38,40) and one required mechanical circulatory support (39). Six patients underwent subsequent percutaneous coronary intervention (33,34,36,37,39,41) and 12 were diagnosed with a STEMI (15,26,27,(31)(32)(33)(34)(35)(36)(37)(38)41) (Table 6). Due to significant comorbidities, including previous cardiac surgery, COPD, diabetes and previous CVA, all patients underwent percutaneous repair with a closure device.…”

Section: Ventricular Pseudoaneurysmmentioning

confidence: 99%

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Systematic review and meta-analysis of the mechanical complications of ischemic heart disease: papillary muscle rupture, left ventricle rupture and post-infarct ventricular septal defect

Flynn¹,

Morris²,

Manuel³

et al. 2022

Ann Cardiothorac Surg

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Background: Improvements in revascularisation, including pharmacological, catheter-based and surgical, have resulted in improved outcomes for patients with acute myocardial infarction (AMI), leading to decreased frequency of mechanical complications. Improvements in both techniques and technology have permitted select patients to be managed with a purely percutaneous, transcatheter strategy. Through systematic review, this study aims to synthesise the collective experience of percutaneous treatment of the mechanical complications of ischaemic heart disease. Methods: The search strategy queried the electronic databases PubMed, Embase and the Cochrane Central Register of Controlled Trials, from 1 January 2000 to 31 December 2020. Studies highlighting the outcomes of patients receiving percutaneous treatment of post-myocardial infarction papillary muscle rupture (PMR), ventricular septal defect (VSD), left ventricular free wall rupture (FWR) and pseudoaneurysm (PA) were included. A qualitative review of studies was conducted for PMR, FWR and PA. A quantitative analysis was conducted for VSD.Results: Fifteen studies were included in the qualitative synthesis of the percutaneous management of PMR, 4 were included in the qualitative analysis of the percutaneous management of left ventricular FWR, 7 studies defined the outcomes of the percutaneous management of PA and 25 were included in the quantitative meta-analysis of the primary percutaneous management of post-MI VSD. For VSD, there were 43 failed procedures in 314 patients. The proportion of failed procedures was 15.9% and there were 174 deaths in 428 patients. 37.5% of patients experienced early mortality.Conclusions: Although surgical techniques remain the gold standard, we have shown that percutaneous management may be a viable option in certain cases.

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Section: Resultsmentioning

confidence: 99%

Section: Ventricular Pseudoaneurysmmentioning

confidence: 99%

Section: Ventricular Pseudoaneurysmmentioning

confidence: 99%

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Systematic review and meta-analysis of the mechanical complications of ischemic heart disease: papillary muscle rupture, left ventricle rupture and post-infarct ventricular septal defect

Flynn¹,

Morris²,

Manuel³

et al. 2022

Ann Cardiothorac Surg

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“…Congenital heart defect repair (Ross procedure [24], ventricular septal defect (Swiss-cheese) repair [66] [7,31,35,36,41,43,51,52], and the remaining 42 (80.8%) patients had 59 symptoms, with chest pain and dyspnoea/shortness of breath being the most common (Table II). The ejection fraction of the patients was 31.6 ±13.9% (range: 16-55%; median: 25%) (n = 7) [15,36,42,45,53,55,68].…”

Section: Resultsmentioning

confidence: 99%

Percutaneous closure of left ventricular pseudoaneurysm

Yuan¹

2022

pwki

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The aim of the present study is to describe the indications, treatment effects, and patient outcomes of percutaneous management of left ventricular pseudoaneurysm (LVPA). The study materials were based on comprehensive literature retrieval since 2004. The mechanisms of LVPA formation can be divided into surgical, percutaneous, and medial disease related. Of the surgical mechanisms, coronary artery bypass grafting prevailed. The formation time was the longest in medical disease-related LVPAs up to 44.4 months. The percutaneous procedures succeeded on the first try in 79 (84.9%) patients, whereas failures were encountered during the percutaneous manoeuvres in 14 (15.1%) patients. Percutaneous closure of LVPA was especially indicated for patients carrying a high surgical risk. The iatrogenic traumas, such as left ventricular venting, should be avoided to prevent this complication. The preliminary cut-off valves of oversize 3.3 mm and oversize ratio 1.6 should be followed for reference for device choice.

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“…Prior studies have demonstrated the heightened risk of thromboembolism and ventricular free wall rupture when ventricular pseudoaneurysms are not surgically managed, with annual rupture rates of 30%–45% 10, 11. In patients who are not operative candidates, there have been several explorations into the possibility of percutaneous closure, with varying success 12, 13. Though the data on prognosis and management of left ventricular pseudoaneurysms are sparse, even less data are available on RV pseudoaneurysms, leaving uncertainty in the optimal management strategy.…”

Section: Discussionmentioning

confidence: 99%

Lead extraction complicated by right ventricular pseudoaneurysm: Percutaneous closure with septal occluder device

Singleton

Brunetti

Schoenfeld

et al. 2019

HeartRhythm Case Reports

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Percutaneous Closure of a Left Ventricular Pseudoaneurysm Causing Recurrent Embolization, With Cerebral Protection and Extracorporeal Membrane Oxygenation Support

Cited by 6 publications

References 1 publication

Systematic review and meta-analysis of the mechanical complications of ischemic heart disease: papillary muscle rupture, left ventricle rupture and post-infarct ventricular septal defect

Systematic review and meta-analysis of the mechanical complications of ischemic heart disease: papillary muscle rupture, left ventricle rupture and post-infarct ventricular septal defect

Percutaneous closure of left ventricular pseudoaneurysm

Lead extraction complicated by right ventricular pseudoaneurysm: Percutaneous closure with septal occluder device

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