Left ventricular perforation in a patient with a left ventricular aneurysm during NOGA® catheter mapping

Cardiovasc Revasc Med. 2018 Dec;19(8S):50-52. doi: 10.1016/j.carrev.2017.05.011. Epub 2017 May 13.


Endocardial mapping of the left ventricle (LV) using the NOGA® XP Cardiac Navigation System can identify chronically ischemic and viable myocardium in patients with coronary artery disease by generating electromechanical maps. These maps are very useful when targeting myocardial tissue for injection of stem cells. We present the case of a woman who developed a perforation at the site of an LV aneurysm during NOGA mapping prior to the transendocardial injection of stem cells, as part of a multicenter clinical trial. The presence of an LV aneurysm is currently not a contraindication (or caution) to the use the NOGA mapping catheter. As the field of stem cell therapy evolves and the use of this technique increases, operators must be aware that the presence of an LV aneurysm may increase the risk of perforation during a NOGA mapping procedure.

Keywords: Left ventricle aneurysm; Left ventricular perforation; NOGA® catheter; RENEW clinical trial.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Body Surface Potential Mapping / adverse effects*
  • Body Surface Potential Mapping / instrumentation
  • Cardiac Catheterization / adverse effects*
  • Cardiac Catheterization / methods
  • Diagnosis, Differential
  • Echocardiography
  • Female
  • Heart Aneurysm / diagnosis
  • Heart Aneurysm / etiology*
  • Heart Injuries / complications*
  • Heart Injuries / diagnosis
  • Heart Ventricles / diagnostic imaging
  • Heart Ventricles / injuries*
  • Heart Ventricles / physiopathology
  • Humans
  • Imaging, Three-Dimensional
  • Myocardial Ischemia / diagnosis*
  • Radionuclide Ventriculography