Spontaneous regression of submitral pseudoaneurysm after radiofrequency catheter ablation in a patient with Wolff-Parkinson-White syndrome Dongmin Kim,

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Presentation transcript:

Spontaneous regression of submitral pseudoaneurysm after radiofrequency catheter ablation in a patient with Wolff-Parkinson-White syndrome Dongmin Kim, MD, Myung-Yong Lee, MD HeartRhythm Case Reports Volume 4, Issue 12, Pages 580-583 (December 2018) DOI: 10.1016/j.hrcr.2018.09.002 Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 1 A: Surface electrocardiography and intracardiac electrograms from the ablation catheter positioned in the inferior septal mitral annulus show the changing atrial activation sequence (arrow) of the coronary sinus after initiation of radiofrequency energy (arrowhead) during pacing at the right ventricle. Corresponding catheter position (ablation catheter [Abl]) in the left anterior oblique (B) and right anterior oblique (C) projections. dCS = distal coronary sinus; pCS = proximal coronary sinus. HeartRhythm Case Reports 2018 4, 580-583DOI: (10.1016/j.hrcr.2018.09.002) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 2 Serial follow-up of contrast-enhanced computed tomography of the left ventricular pseudoaneurysm. A: At presentation, a round enhancing mass (arrows) was shown at the base of the left ventricle proximal to the coronary sinus. A large amount of pericardial effusion (PE) was observed. B: Immediate postpericardial drainage (yellow arrow); the image shows a 2.7 × 1.7 cm outpouching (arrow) arising from the basal inferior left ventricular wall connected to the narrow track (arrowhead) just beneath the mitral annulus. C: At 3 months after the event, the pseudoaneurysm (arrows) regressed to a size of 1.2 × 0.8 cm. HeartRhythm Case Reports 2018 4, 580-583DOI: (10.1016/j.hrcr.2018.09.002) Copyright © 2018 Heart Rhythm Society Terms and Conditions

Figure 3 Transthoracic echocardiographic parasternal long-axis view of the left ventricular pseudoaneurysm. A: A left ventricular pseudoaneurysm (2.5 × 1.6 cm) is indicated by the white arrows. A large amount of pericardial effusion (PE) was noted. B: Color Doppler imaging displays the neck of the pseudoaneurysm at the interior margin of the mitral annulus (arrowhead). Flow into the pseudoaneurysm during systole is illustrated. C, D: At 6 months after the event, the pseudoaneurysm was not evident, and color flow mapping shows no abnormal flow except for mild mitral regurgitation. HeartRhythm Case Reports 2018 4, 580-583DOI: (10.1016/j.hrcr.2018.09.002) Copyright © 2018 Heart Rhythm Society Terms and Conditions