Video : Complex Coronary PCI with LV assist device - TAVI procedure with Brachial access

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Cardiology / Coronary / Pci / Case in the box

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CASE 01: Complex LAD PCI in patient with severe three vessels disease and severe LVEF -Dr.Antonio COLOMBO

This coronary PCI procedure concerns a 80 years old male , with medical history of diabetes mellitus, Chronic Kidney disease and atrial fibrillation

Presenting Heart failure III NYHA and diffuse severe coronary artery disease ,The procedure was performed with LV assist device.

Strategy Plan

Imaging studies

Coronary angiography: Three vessels disease: Proximal RCA CTO , significant LM stenosis, diffusely calcified LAD lesions and Lcx calcified stenosis ,
Echo: LV EF dysfunction 30%

Clinical indication

Heart failure III NYHA
Heart Team decision

Planned Procedure

LV assist device Impella 2.5
PCI the LAD and LCx with Rotational atherectomy

CASE 02: TAVI Procedure for severe aortic regurgitation with trans-Proximal Brachial artery access -Dr.Matteo MONTORFANO

This Trans-brachial TAVI procedure concerns a young female of 37 years , with medical history of aortic subvalvular fibromuscular aortic stenosis treated with aortic homograft and surgical resection 20 years ago,

Presenting Heart failure II NYHA with severe aortic regurgitation treated with TAVI performed by Brachial access.

Strategy Plan

Imaging studies

Echo: LVEF dysfunction 65%, severe aortic regurgitation,
CT scann: virtual basal ring permeter:54mm , virtual basal ring area:225.2mm² , occluded right iliac artery , small left iliac artery

Clinical indication

Heart failure II NYHA
Patient refuses mechanical prosthesis

Planned Procedure

Left proximal brachial access
TAVI with Corevalve Evolut R

Shooting date : 2018-02-22
Last update : 2021-06-09