Division of Cardiovascular Surgery, Pronto Socorro Cardiológico de Pernambuco-PROCAPE, Recife, Brazil.
University of Pernambuco-UPE, Recife, Brazil.
J Card Surg. 2021 Jun;36(6):2113-2116. doi: 10.1111/jocs.15407. Epub 2021 Feb 5.
Left ventricular aneurysms (LVA) are serious complications of myocardial infarction, being divided into true and false type. The false one-pseudoaneurysm (PA), is a life-threatening condition that requires urgent treatment due to the high risk of rupture.
An 84-year-old female presented with progressive heart failure symptoms. Investigation showed a small true LVA and a large PA. Open surgical repair was ruled out as Euroscore and Society of Thoracic Surgeons (STS) score were 42.80% and 39.97%, respectively. After discussion at our Heart Team meeting, percutaneous approach was found to be the best option. Guided by transesophageal echocardiography, we used an interventricular septal defect occluder to close the gap between the LV and the PA. Control ventriculography showed full closure of the gap, with no residual flow to the PA cavity. The patient was discharged from the hospital on the fifth postoperative day and has remained asymptomatic since then.
Percutaneous approach proved to be a safe and effective modality to treat LV PA. The device implanted achieved the goal of blocking blood flow through the communication between LV and the PA.
左心室瘤（LVA）是心肌梗死的严重并发症，可分为真性和假性。假性的即假性动脉瘤（PA），是一种危及生命的情况，由于破裂的高风险，需要紧急治疗。
一位 84 岁女性因进行性心力衰竭症状就诊。检查显示存在一个小的真性 LVA 和一个大的 PA。由于 Euroscore 和胸外科医师协会（STS）评分分别为 42.80%和 39.97%，开胸手术修复被排除在外。在我们的心脏团队会议上讨论后，发现经皮方法是最佳选择。在经食管超声心动图的引导下，我们使用室间隔缺损封堵器来关闭 LV 和 PA 之间的间隙。心室造影显示完全关闭了间隙，没有血流残余到 PA 腔。患者术后第 5 天出院，此后一直无症状。
经皮方法被证明是治疗 LV PA 的一种安全有效的方式。植入的器械实现了通过 LV 和 PA 之间的连通来阻止血流的目标。
