Discussion
Endovascular technologies are increasingly available to clinicians as options for minimally invasive approaches to complex pathologies [2–6]. While an anastomotic pseudoaneurysm following aortic root replacement is a rare sequela, it poses a challenge given the added morbidity and potential mortality of a reoperative sternotomy [7,8]. The AmplatzerTM Septal Occluder has been previously used in a limited fashion for percutaneous closure of aortic pseudoaneurysms in 13 cases, of whom only two had prior aortic root replacements [5,6]. While there is some evidence that transcatheter approaches may not be effective, we present a clinical scenario of a postoperative pseudoaneurysm arising from the left ventricular outflow tract (LVOT) of a patient who had previously undergone a composite root replacement [3]. Given the morbidity and potential mortality of an open repair, the patient underwent a successful percutaneous transcatheter repair with radiographic resolution seen two years following the intervention. This case adds to recent literature suggesting that alternative techniques to open repair may be safe and durable for the salvage of composite root replacements with pseudoaneurysmal complications. While the transcatheter repair has been limited to patients who are truly not operative candidates, it can be a useful tool to employ depending upon the resources available to the clinician and preferences of the patient.