Protected Percutaneous Coronary Intervention (PCI) of Cabrol Type Anastomosis of Saphenous Vein Graft (SVG) to the Left Main Coronary Artery (LMCA).
cabrol type anastomosis
hemodynamics
impella cp
physiology
pulsatility
Journal
Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737
Informations de publication
Date de publication:
25 Jun 2020
25 Jun 2020
Historique:
entrez:
4
8
2020
pubmed:
4
8
2020
medline:
4
8
2020
Statut:
epublish
Résumé
The use of percutaneous left ventricular assist devices (VAD) may minimize the risk of hemodynamic compromise during such high-risk percutaneous coronary intervention (PCI) and allow complete revascularization, thus improving outcomes. A good understanding of cardiac hemodynamics is essential in making informed decisions during such cases. A 61-year-old male with an extensive surgical cardiac history including a modified Cabrol type anastomosis with saphenous vein (SVG) conduits to two coronary arteries presented to our hospital with severe substernal chest discomfort and was noted to have diffuse ST depressions along with subtle ST elevations in lead aVR suggestive of diffuse sub-endocardial ischemia. Diagnostic coronary angiography revealed significant stenosis in the Cabrol type SVG grafts and we opted for a protected PCI using Impella (Abiomed, Danvers, MA) support. A significant drop in the blood pressure was noted and despite trouble-shooting, the Impella arterial line tracing remained minimally pulsatile. A comprehensive understanding of circulatory support physiology was ultimately crucial in making an informed decision for a successful PCI outcome.
Identifiants
pubmed: 32742841
doi: 10.7759/cureus.8829
pmc: PMC7384709
doi:
Types de publication
Case Reports
Langues
eng
Pagination
e8829Informations de copyright
Copyright © 2020, Siddiqui et al.
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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