[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-455420-105":59,"doc-detail-455420-en":131},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":124,"head_meta":126,"extra_data":128,"updated_unix":130},105,"en","transcatheter-closure-of-an-ascending-aortic-pseudoaneurysm-guided-by-intracardiac-echocardiography","Transcatheter Closure of an Ascending Aortic Pseudoaneurysm Guided by Intracardiac Echocardiography","","A 60-year-old man with multiple prior cardiac surgeries developed exertional dyspnea. CT identified a 20 × 10 mm ascending aortic pseudoaneurysm near a previous aortic root replacement suture line, with a 7 mm neck, compressing a saphenous vein graft (SVG). Because reoperation carried high risk, percutaneous catheter closure using a 9/12 mm Amplatzer Vascular Plug II (AVP II) was performed with drug-eluting stent implantation to treat SVG stenosis. Intraoperative intracardiac echocardiography (ICE) enabled precise AVP II deployment and confirmed correct placement, supporting the safety and effectiveness of ICE-guided minimally invasive management.",{"@graph":69,"@context":123},[70,84,106],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/transcatheter-closure-of-an-ascending-aortic-pseudoaneurysm-guided-by-intracardiac-echocardiography/455420/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/transcatheter-closure-of-an-ascending-aortic-pseudoaneurysm-guided-by-intracardiac-echocardiography/455420.png","ImageObject",300,407,{"name":92,"@type":93},"moss~","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-06","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":105},"InteractionCounter",{"@type":104},"ViewAction",14,{"@type":107,"mainEntity":108},"FAQPage",[109,115,119],{"name":110,"@type":111,"acceptedAnswer":112},"What condition was diagnosed in the patient?","Question",{"text":113,"@type":114},"A 20 × 10 mm ascending aortic pseudoaneurysm with a 7 mm neck was identified near the prior aortic root replacement suture line.","Answer",{"name":116,"@type":111,"acceptedAnswer":117},"Why was percutaneous closure chosen instead of reoperation?",{"text":118,"@type":114},"Reoperation was considered high risk due to the patient’s history of multiple prior cardiac surgeries.",{"name":120,"@type":111,"acceptedAnswer":121},"What role did intracardiac echocardiography (ICE) play?",{"text":122,"@type":114},"ICE provided real-time guidance to ensure accurate AVP II deployment and confirm appropriate placement during the procedure.","https://schema.org",{"og:url":83,"og:type":125,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":127,"canonical":83},"index,follow",{"doc_id":129,"site_id":62},455420,1790794126,{"code":4,"msg":5,"data":132},{"doc_id":129,"user_id":133,"nickname":92,"user_avatar":134,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":135,"file_id":136,"file_url":137,"file_type":138,"file_size":139,"view_count":105,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":34,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145,"preview_page_count":4},962090895452,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Review began 06/01/2025  \nReview ended 12/03/2025  \nPublished 12/08/2025  \n© Copyright 2025  \nSato et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0. , which permits unrestricted use , distribution , and reproduction in any medium , provided the original author and source are credited.  \nDOI: 10.7759/cureus.98755  \nOpen Access Case Report  \nTranscatheter Closure of an Ascending Aortic Pseudoaneurysm Guided by Intracardiac Echocardiography  \nManabu Sato 1 , Hiromasa Hayama 1, Yae Matsuo 2 , Yoshiyuki Yazaki 1, Kenji Makino 1, Go Hashimoto 1 , Hidehiko Hara 1  \n1. Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, JPN 2. Division of Cardiovascular Medicine, North Kanto Cardiovascular Hospital, Tokyo, JPN  \nCorresponding author: Manabu Sato, [ms.0913.shctb@gmail.com](ms.0913.shctb@gmail.com)  \nAbstract  \nA 60-year-old man with a history of multiple cardiac surgeries presented with exertional dyspnea. CT revealed a 20 × 10 mm ascending aortic pseudoaneurysm with a neck diameter of 7 mm, located near the suture line of a previous aortic root replacement, compressing a saphenous vein graft (SVG) . Given the high risk of reoperation, percutaneous catheter closure with a 9/12 mm Amplatzer Vascular Plug II (AVP II) was performed alongside drug-eluting stent (4 .0 × 18 mm) implantation to address SVG stenosis. Intraoperative intracardiac echocardiography (ICE) was essential for guiding AVP II deployment and ensuring accurate placement. This case highlights the effectiveness and safety of ICE-guided percutaneous interventions in managing complex aortic pathologies in high-risk patients. Successful closure of the pseudoaneurysm and resolution of the SVG compression demonstrated the feasibility of this minimally invasive approach inpatients with complex surgical histories.  \nCategories: Cardiology, Internal Medicine, Cardiac/Thoracic/Vascular Surgery  \nKeywords: amplatzer vascular plug ii, aortic pseudoaneurysm, cardiac surgeries, case report, intracardiac  \nechocardiography, percutaneous  \nIntroduction  \nAscending aortic pseudoaneurysm occurs in less than 0.5% of patients following cardiac surgical procedures  \n[1] . Although rare, it is a potentially life-threatening condition. It can develop due to vascular wall injury from cardiac surgery and carries the risks of thrombosis, embolism, and rupture, which may be fatal, thus requiring therapeutic intervention. Surgical repair is the standard treatment [2]; however, reoperation carries significant risks, particularly for patients who have undergone multiple cardiac surgeries. In these cases, percutaneous catheter-based interventions are viable alternatives. Advances in percutaneous catheter techniques have reduced the morbidity and mortality associated with these procedures [3,4] . Previous case reports have demonstrated that the Amplatzer Vascular Plug II (AVP II) can be a safe and effective option for transcatheter closure of ascending aortic pseudoaneurysms, particularly in patients at high surgical risk [5- 7] .  \nAscending aortic pseudoaneurysms are typically diagnosed by using multiple imaging modalities. A comprehensive evaluation of pseudoaneurysms and detailed anatomical features is essential for determining the appropriate catheter-based treatment strategy. When a catheter-based intervention is selected, intraoperative transesophageal echocardiography (TEE) is often performed in conjunction with fluoroscopic guidance for real-time monitoring [8] . However, visualization using TEE can be challenging due to prosthetic devices, such as mechanical valves, or anatomical alterations [9] . Intracardiac echocardiography (ICE) is a catheter-based ultrasound modality that allows real-time visualization from within the right atrium and  \nhelps identify cardiac and adjacent pericardiac structures.  \nThis report demonstrates a successful case of percutaneous intraoperative ICE for an ascendin","cbCailUp7hqzJODH","https://ap.wps.com/l/cbCailUp7hqzJODH","pdf",3530453,"English","# Abstract\n# Introduction\n# Case Presentation\n## Medical history and presentation\n## Imaging findings\n## Procedure and outcomes","[{\"question\":\"What condition was diagnosed in the patient?\",\"answer\":\"A 20 × 10 mm ascending aortic pseudoaneurysm with a 7 mm neck was identified near the prior aortic root replacement suture line.\"},{\"question\":\"Why was percutaneous closure chosen instead of reoperation?\",\"answer\":\"Reoperation was considered high risk due to the patient’s history of multiple prior cardiac surgeries.\"},{\"question\":\"What role did intracardiac echocardiography (ICE) play?\",\"answer\":\"ICE provided real-time guidance to ensure accurate AVP II deployment and confirm appropriate placement during the procedure.\"}]","Transcatheter Closure of an Ascending Aortic Pseudoaneurysm Guided by Intracardiac Echocardiography | PDF",1790742835,18]