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封堵渗漏:经皮封堵左心室假性动脉瘤

Sealing the Leak: Percutaneous Closure of a Left Ventricular Pseudoaneurysm.

作者信息

Taylor Jeffrey, Barboza Joaquim, Ibrahim Khalil, Abdelhady Khaled

机构信息

Division of Cardiology, University of Illinois Chicago, Chicago, Illinois, USA.

Division of Cardiology, University of Illinois Chicago, Chicago, Illinois, USA.

出版信息

JACC Case Rep. 2025 Jul 30;30(21):104343. doi: 10.1016/j.jaccas.2025.104343.

Abstract

Left ventricular pseudoaneurysm (LVPA) is a rare but potentially life-threatening complication. Although surgical repair remains the gold standard, percutaneous closure has emerged as a less invasive and feasible option for high-risk surgical candidates. We present the case of a 76-year-old woman with 2 prior sternotomies for mitral valve repair and subsequent replacement, who presented with worsening dyspnea on exertion. A computed tomography scan performed to rule out pulmonary embolism led to the incidental discovery of an LVPA. We describe a percutaneous approach using multimodal imaging guidance for successful coiling and closure of the LVPA with an Amplatzer ventricular septal defect occluder device.

摘要

左心室假性动脉瘤(LVPA)是一种罕见但可能危及生命的并发症。尽管手术修复仍是金标准,但对于高风险手术患者,经皮封堵已成为一种侵入性较小且可行的选择。我们报告一例76岁女性病例,该患者曾因二尖瓣修复及后续置换术接受过两次胸骨切开术,现出现劳力性呼吸困难加重。为排除肺栓塞而进行的计算机断层扫描偶然发现了LVPA。我们描述了一种在多模态影像引导下的经皮方法,使用Amplatzer室间隔缺损封堵器成功地对LVPA进行了线圈栓塞和封堵。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f117/12441540/7e0485cf884b/ga1.jpg

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