Transapical transcatheter device closure of relapse left ventricular diverticulum: a novel minimally invasive technique for reoperation

We describe a novel minimally invasive technique, transapical transcatheter device closure of relapse left ventricular diverticulum (LVD) under transesophageal echocardiography (TEE) guidance. The patient previously underwent LVD primary repair and mitral valvular replacement. The anatomical characteristics of the relapse LVD and its adjacent structures are detailedly delineated by echocardiography. The relapse LVD is then managed by transapical transcatheter device closure under TEE guidance. This novel minimally invasive technique is not only limited in relapse LVD, but also could be extensively applied in other cardiac reoperation, such as perivalvular leak closure after valvular replacement.