If you don't remember your password, you can reset it by entering your email address and clicking the Reset Password button. You will then receive an email that contains a secure link for resetting your password
If the address matches a valid account an email will be sent to __email__ with instructions for resetting your password
A 61-year-old man with a history of postischemic dilated cardiomyopathy was referred
in advanced congestive heart failure to our department (Department of Cardiology).
He had a history of acute inferolateral myocardial infarction complicated by left
ventricular (LV) aneurysm treated elsewhere by coronary artery bypass grafts, aneurysm
resection, and automatic implantable cardioverter defibrillator implantation a few
years before. At the time of admission, he was in functional New York Heart Association
class III-IV with signs and symptoms of congestive heart failure and low cardiac output.
At echocardiography, left cardiac chamber enlargement and severe LV hypokinesis (ejection
fraction < 30% by Simpson method) were imaged. The LV was compressed and distorted
by a huge pseudoaneurysm located between the inferior and posterior-lateral wall,
resulting in severe mitral valve regurgitation (Fig. 1A). On the computed tomography scan, the site and size (11.8 × 6 cm) of the LV pseudoaneurysm
were better detailed (Fig. 1B). Because of the perceived high surgical risk, a 2-step percutaneous treatment was
planned. First, the pseudoaneurysm was imaged (Fig. 1C) and probed from the aortic route. Then, its mouth was carefully sized with an Equalizer
Occlusion balloon (Boston Scientific, Cork, Ireland) and occluded by implantation
of a 28-mm Amplatzer septal occluder device (Abbott, Plymouth, MN) (Fig. 2A, Video 1 , view video online) under transesophageal echocardiography guidance. Two months later,
the mitral valve regurgitation was treated by sequential implantation of 3 MitraClip
devices (Abbott Vascular, Santa Clara, CA) with a standard technique under 3-dimensional
transesophageal echocardiography guidance. At the end of the procedures, no flow into
the aneurysmal sac and just mild mitral regurgitation were imaged (Fig. 2B, Video 2 , view video online). At the 6-month follow-up evaluation, the patient was asymptomatic
and in functional New York Heart Association class I-II under mild antifailure therapy.
To read this article in full you will need to make a payment