Case 110: PCI Manual - Complicated PCI before TAVR

A patient with exertional dyspnea was found to have severe left main and LAD lesions and severe aortic stenosis. A decision was made to perform PCI followed by TAVR. An Impella CP device was inserted after aortic balloon valvuloplasty. PCI of the LAD was complicated by slow flow in the diagonal. Attempts to rewire the diagonal with a TwinPass Torque and Sion black wire were complicated by large vessel peroration that was sealed with a PK Papyrus stent. The left main was treated with orbital atherectomy into the circumflex, followed by stenting using the DK crush technique. The patient developed atrial fibrillation and tamponade 3 days later requiring pericardiocentesis. TAVR was subsequently performed and was compicated by LVOT obstruction. The patient was eventually discharged in good condition.

Видео Case 110: PCI Manual - Complicated PCI before TAVR канала Manos Brilakis