Intercostal artery pseudoaneurysm: a rare complication of transaortic transcatheter aortic valve implantation

Interact Cardiovasc Thorac Surg. 2012 Sep;15(3):550-2. doi: 10.1093/icvts/ivs188. Epub 2012 Jun 8.

Abstract

In this case report, we present an 86-year old patient with an intercostal pseudoaneurysm after transaortic transcatheter aortic valve implantation (TAVI). This new technique of a transaortic approach is considered a possible alternative to the more usual transfemoral, trans-subclavian or transapical access site, mainly in patients with extensive peripheral arterial disease. A mini-thoracotomy or mini-sternotomy is needed to access the ascending aorta. The patient presented with a painless but progressive pulsatile mass right parasternally, 3 months after the procedure. An intercostal pseudoaneurysm was diagnosed with duplex examination and chest CT. Successful treatment with an ultrasound-guided injection of thrombin resulted in a complete obliteration of the pseudoaneurysm. Only nine reported cases of intercostal pseudoaneurysms have been reported worldwide, and this is the first case in a patient who underwent a transaortic TAVI. Since the transaortic access is used more frequently, it is important to report on possible complications of this new technique.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Aneurysm, False / diagnosis
  • Aneurysm, False / etiology*
  • Aortic Valve Stenosis / diagnostic imaging
  • Aortic Valve Stenosis / surgery*
  • Cardiac Catheterization / adverse effects*
  • Female
  • Heart Valve Prosthesis Implantation / adverse effects*
  • Heart Valve Prosthesis Implantation / methods
  • Humans
  • Postoperative Complications
  • Thoracic Arteries*
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Duplex