Percutaneous closure of a giant left ventricular pseudoaneurysm using an Amplatzer muscular VSD occluder in a high-risk patient with recurrent heart failure following multiple myocardial infarctions.

While surgical repair has been the conventional therapy, perioperative mortality of 10%-36% renders it prohibitive in patients with multiple comorbidities.

Percutaneous transcatheter closure has emerged as a life-saving alternative for high-risk surgical candidates.

CASE REPORT: A 75-year-old male with prior coronary artery bypass grafting (2010) and two subsequent myocardial infarctions (2019 and 2020) treated with percutaneous coronary intervention presented with refractory decompensated heart failure, massive left pleural effusion, and markedly elevated NT-proBNP (7,172 pg/mL).