Subclavian Impella 5.0 to the rescue in a non-ST elevation myocardial infarction patient requiring unprotected left main rotablation: A case report.
Case report
Impella
Left main
Percutaneous coronary intervention
Rotablation
Subclavian
Journal
World journal of cardiology
ISSN: 1949-8462
Titre abrégé: World J Cardiol
Pays: United States
ID NLM: 101537090
Informations de publication
Date de publication:
26 Apr 2020
26 Apr 2020
Historique:
received:
15
12
2019
revised:
24
03
2020
accepted:
28
03
2020
entrez:
21
5
2020
pubmed:
21
5
2020
medline:
21
5
2020
Statut:
ppublish
Résumé
Often in patients with significant three-vessel or left main disease there is coexistent significant peripheral disease rendering them poor candidates for percutaneous left ventricular support during revascularization. Evidence on the management of such cases is limited. We describe a case of such a patient with critical distal left main disease and chronically occluded right coronary artery who presented with chest pain and a non-ST elevation myocardial infarction and had significantly impaired left ventricular function. With the aid of our cardiothoracic surgeons a cut down subclavian Impella 5.0 was inserted and high risk rotablation percutaneous coronary intervention carried out successfully. This case highlights the need for cross-specialty collaborations in such high-risk cases were alternative access is needed for insertion of large bore mechanical circulatory support devices.
Sections du résumé
BACKGROUND
BACKGROUND
Often in patients with significant three-vessel or left main disease there is coexistent significant peripheral disease rendering them poor candidates for percutaneous left ventricular support during revascularization. Evidence on the management of such cases is limited.
CASE SUMMARY
METHODS
We describe a case of such a patient with critical distal left main disease and chronically occluded right coronary artery who presented with chest pain and a non-ST elevation myocardial infarction and had significantly impaired left ventricular function. With the aid of our cardiothoracic surgeons a cut down subclavian Impella 5.0 was inserted and high risk rotablation percutaneous coronary intervention carried out successfully.
CONCLUSION
CONCLUSIONS
This case highlights the need for cross-specialty collaborations in such high-risk cases were alternative access is needed for insertion of large bore mechanical circulatory support devices.
Identifiants
pubmed: 32431786
doi: 10.4330/wjc.v12.i4.155
pmc: PMC7215966
doi:
Types de publication
Case Reports
Langues
eng
Pagination
155-160Informations de copyright
©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
Déclaration de conflit d'intérêts
Conflict-of-interest statement: Dr Panoulas in receipt of consultancy fees and honoraria from Abiomed.
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