Kar Biswajit, Gholkar Gunjan, Gregoric Igor D, Jain Surendra K, Loyalka Pranav
Department of Adult Cardiology, Texas Heart Institute at St. Luke's Episcopal Hospital, Houston, Texas 77030, USA.
Tex Heart Inst J. 2012;39(5):680-2.
Few cases of percutaneous device closure of a left ventricular pseudoaneurysm have been reported. We describe the case of a 67-year-old man with a history of coronary artery disease who presented with shortness of breath and chest pain. Computed tomographic angiography showed a left ventricular pseudoaneurysm that was filling from a small leak in the anterolateral aspect of the ventricle. The patient had undergone 3 previous sternotomies and was a high-risk candidate for surgical treatment of the pseudoaneurysm. Despite technical challenges, we closed the pseudoaneurysm percutaneously with use of a 6-mm AMPLATZER muscular ventricular septal defect occluder. The patient was released from the hospital the next day and was asymptomatic a year later.To our knowledge, this is the first report of the percutaneous closure of a left ventricular pseudoaneurysm via the femoral vein. We show that this manner of closure can be feasible in patients who have undergone multiple sternotomies and who are at high surgical risk.
经皮装置闭合左心室假性动脉瘤的病例报道较少。我们描述了一名67岁男性患者，有冠状动脉疾病史，出现呼吸急促和胸痛症状。计算机断层血管造影显示左心室假性动脉瘤，由心室前外侧小渗漏供血。该患者曾接受过3次胸骨切开术，是假性动脉瘤手术治疗的高危患者。尽管存在技术挑战，我们仍经皮使用6毫米的AMPLATZER肌部室间隔缺损封堵器闭合了假性动脉瘤。患者次日出院，一年后无症状。据我们所知，这是首例经股静脉经皮闭合左心室假性动脉瘤的报道。我们表明，这种闭合方式对于接受过多次胸骨切开术且手术风险高的患者可能是可行的。
