No, no experience with coil or occluder.  We have use a pericardial patch following MV replacement.  It is a tough surgery to contemplate for sure. I presume with such a narrow neck and dimension an off label Amplatzer might just do the trick!

Dear Josef. I have never treated a Patient in this Situation.

Greetings Thorsten

Dear Dr. Veselka,

We have treated LV pseudoaneurysms post surgery. Amplatzer Devices usually work well. Another important thing that we notice is that sometimes the pseudoaneurysm is not significant when we do a pre-closure lv gram even though they were referred based on CTs. We manage those conservatively and they have done well.

Regards,

Sidakpal

We have just closed the pseudoaneurysm of LV using 7Fr long delivery sheath and Figulla ASD occluder 6 mm.

My compliments. Which maximum size of the neck do you consider acceptable for the percutaneous closure?

Thanks

Stefano Censi

I've only looked after one patient - pseudoaneurysm after MVR (some years ago - in the 90's probably). Surgery was only option, and needed as she had heart failure due to the haemodynamic impact. She was very slow in ITU, but did well in the long run, eventually dying of rheumatic aortic stenosis I think (inoperable at that stage in her life course and pre-TAVI) in her mid 80s. If you can do it percutaneously it'd certainly be better I would suspect!

We performed angiographic 1-month FU today. PSA of LV is completely occluded. 

Similar case with a fistula into coronary sinus, which was not our case, was published by Mayo people in the Can J Cardiol 2 years ago. 

I had a case of post PTCA stenting stent thrombosis with myocardial infarction with LV pseudoaneurysm formation. Patient had undergone CABG and surgical closure of LV rapture site. Patient is doing well.This Case will be published in coming issue of Nigerian journal of cardiology.