Transcatheter Intervention for Complex Ascending Aortic Pseudoaneurysm After Cardiac Surgery
Resource
Circ. J., 78(9), 2215-2218
Journal
Circulation Journal
Pages
2215-2218
Date Issued
2014
Date
2014
Author(s)
Yin, Wei-Hsian
Wei, Jeng
Tsai, Shen Kou
Hsiung, Ming C.
Lee, Yung-Tsai
Yu, Ho-Ping
Ou, Ching-Huei
Abstract
Background: Ascending aortic pseudoaneurysm (PsA) is an uncommon but surgically challenging problem with high morbidity and mortality. Herein we describe the efficacy and safety of the different approaches to transcatheter intervention for repair of ascending PsA and assess the selection of occluder devices using real-time 3-dimensional (RT 3D) color Doppler transesophageal echocardiography (TEE).
Methods and Results: Three patients with complex ascending PsA after cardiac or aortic root surgery were treated with transcatheter intervention due to high risk for redo surgery. Perioperative RT 3D-TEE combined with fluoroscopy was used for monitoring. All ascending PsA were successfully occluded with different devices using the transcatheter technique either with the transapical, transarterial approach, or transvenous combined with hybrid process depending on lesion anatomy.
Conclusions: Treatment of complex ascending PsA with transcatheter or combined hybrid intervention with cautious planning based on patient presentation and well-coordinated teamwork was successful. RT 3D color Doppler TEE provided precise information for the selection of appropriate occluder device, and also facilitated the procedure by guiding the catheter through difficult anatomy.
Subjects
Aortic pseudoaneurysm
Cardiac surgery
Real-time 3-dimensional transesophageal echocardiography (RT 3D-TEE)
Transcatheter combined hybrid intervention
Transcatheter intervention
SDGs
Other Subjects
adult; aorta disease; aortography; Article; artificial embolism; case report; computer assisted tomography; coronary artery bypass graft; false aneurysm; female; fluoroscopy; heart surgery; human; image analysis; male; middle aged; postoperative period; septal occluder; thorax radiography; transcatheter aortic valve implantation; transesophageal echocardiography; treatment outcome; adverse effects; Aneurysm, False; aorta; Aortic Aneurysm; echography; heart surgery; postoperative complication; three dimensional echocardiography; transesophageal echocardiography; Aneurysm, False; Aorta; Aortic Aneurysm; Cardiac Surgical Procedures; Echocardiography, Three-Dimensional; Echocardiography, Transesophageal; Humans; Male; Middle Aged; Postoperative Complications