eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Editorial board Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
1/2021
vol. 17
 
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abstract:
Image in intervention

Balloon aortic valvuloplasty, Impella insertion and complex coronary intervention: is this all feasible fully percutaneously via upper limb access?

Jerzy Sacha
1, 2
,
Krzysztof Krawczyk
2
,
Maciej Gawor
3
,
Joanna Płonka
2
,
Marek Gierlotka
2

1.
Faculty of Physical Education and Physiotherapy, Opole University of Technology, Opole, Poland
2.
Department of Cardiology, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
3.
Department of Anesthesiology and Intensive Care, University Hospital, Institute of Medical Sciences, University of Opole, Opole, Poland
Adv Interv Cardiol 2021; 17, 1 (63): 126–128
Online publish date: 2021/03/27
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Complex high-risk indicated patients (CHIP) with a limited vascular access constitute a real challenge for percutaneous coronary interventions (PCI), particularly if they require mechanical circulatory support devices. A 73-year-old man with recent non-ST segment elevation myocardial infraction, depressed left ventricular function (ejection fraction, 40%), aortic stenosis (max/mean gradient, 50/32 mm Hg; aortic valve area and its index, 1.0 cm2 and 0.5 cm2/m2) and numerous comorbidities (including recently diagnosed lung cancer in the initial phase) was scheduled by the heart team for balloon aortic valvuloplasty (BAV) and Impella-supported complex PCI of the left main (LM) and the left anterior descending artery (LAD) (Figure 1 A) – the dominant right coronary artery was chronically occluded without the viability of the corresponding myocardium. Due to the abdominal aortic aneurysm with intraluminal thrombus, the procedure could only be performed via upper limb access, and the following interventional images demonstrate how to do it fully percutaneously without general anesthesia.
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