Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital and College of Medicine, Tainan, Taiwan.
Ann Thorac Surg. 2013 Feb;95(2):707-9. doi: 10.1016/j.athoracsur.2012.06.020.
Surgical repair of a left ventricular pseudoaneurysm is challenging. Percutaneous closure with an AMPLATZER Septal Occluder (AGA Medical Corporation, Golden Valley, MN) has evolved to be an effective alternative to conventional surgery with less complication. We report a case of severe hemolytic hyperbilirubinemia and acute renal failure after percutaneous left ventricular pseudoaneurysm endoprothesis repair, which required conventional surgical repair through a left thoracotomy to treat this complication. The rationale and results of such an off-the-label usage of AMPLATZER Septal Occluder were reexamined. Residual leakages were not rare findings in the reviewed literature. The indications for this approach should be individualized.
左心室假性动脉瘤的手术修复颇具挑战性。经皮应用 AMPLATZER Septal Occluder（AGA Medical Corporation，明尼苏达州 Golden Valley）进行封堵已成为传统手术的有效替代方法，且并发症更少。我们报告了一例经皮左心室假性动脉瘤内支架修复术后出现严重溶血性高胆红素血症和急性肾衰竭的病例，该患者需要通过左开胸手术进行传统手术修复来治疗这一并发症。我们重新审查了这种 AMPLATZER Septal Occluder 的超适应证使用的原理和结果。在回顾的文献中，残余漏并不少见。这种方法的适应证应个体化。
