Mechanical circulatory support with impella to facilitate percutaneous coronary intervention for post‐TAVI bilateral coronary obstruction |
| |
Authors: | Tiberio M. Frisoli MD Mayra Guerrero MD FACC FSCAI William W. O'Neill MD FACC FSCAI FAHA |
| |
Affiliation: | 1. Division of Cardiology, Henry Ford Health System, Heart and Vascular Institute, Detroit, Michigan;2. Division of Cardiology, Henry Ford Health System, Center for Structural Heart Disease, Detroit, Michigan |
| |
Abstract: | One of the potential complications of transcatheter aortic valve implantation (TAVI) is coronary obstruction (CO), which can occur by displacement of heavily calcified native valve cusps against the coronary ostium. Treatment mandates immediate percutaneous coronary intervention (PCI) to restore coronary flow and improve hemodynamics and if unsuccessful, urgent implementation of circulatory support, commonly extracorporeal, with subsequent surgical revascularization. We report a case of post‐TAVI CO for which successful emergent deployment of Impella percutaneous mechanical circulatory support to restore hemodynamic stability facilitated definitive treatment with bilateral PCI. Impella support represents an expeditious, effective, and widely available therapy to complement and facilitate PCI in the treatment of CO complicating TAVI, and may diminish requirement for urgent coronary artery bypass surgery. © 2015 Wiley Periodicals, Inc. |
| |
Keywords: | aortic valve stenosis coronary intervention cardiogenic shock |
|
|