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Aortic intervention guided by contrast-enhanced transoesophageal ultrasound whist waiting for cardiac transplantation: a case report.


ABSTRACT:

Background 

Aortic complications can happen during left ventricular assist devices (LVADs) insertion and its treatment remains challenging. Percutaneous aortic interventions can be an alternative to surgery in such high-risk cases.

Case summary 

We present a patient with idiopatic dilated cardiomyopathy and advanced heart failure requiring LVAD insertion as a bridge to transplant, who developed an aortic pseudoaneurysm below the anastomosis of the LVAD tube. He was successfully treated with percutaneous coiling under contrast-enhanced transoesophageal echocardiography (TOE) guidance, reaching destination therapy (heart transplantation) a year later.

Discussion 

Left ventricular assist devices provide haemodynamic support for patients with advanced heart failure waiting for heart transplantation. Although uncommon, aortic complications can happen as a result of LVAD insertion and be life-threatening. Percutaneous aortic interventions can be performed in such cases to promote thrombosis and remodelling of false lumen or aneurysmatic spaces, hence potentially reducing the risk of sudden death. Contrast-enhanced TOE can be easily and safely used to monitor the intervention in order to improve anatomic definition, guide positioning of wires and catheters and assess early results.

SUBMITTER: Castro Verdes M 

PROVIDER: S-EPMC7850615 | biostudies-literature |

REPOSITORIES: biostudies-literature

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