Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function

Piotr Kübler; Grzegorz Onisk; Maciej Rachwalik; Roman Przybylski; Krzysztof Reczuch; Marcin Protasiewicz

doi:10.5114/aic.2021.104781

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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Image in intervention

Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function

Piotr Kübler

¹

,

Grzegorz Onisk

¹

,

Maciej Rachwalik

²

,

Roman Przybylski

³

,

Krzysztof Reczuch

¹

,

Marcin Protasiewicz

⁴

Department of Heart Diseases, Wroclaw Medical University, Wroclaw, Poland
Department and Clinic of Cardiac Surgery, Wroclaw Medical University, Wroclaw, Poland
Clinic of Cardiac Transplantation and Mechanical Circulatory Support, Wroclaw Medical University, Wroclaw, Poland
Cardiology Department, Wroclaw Medical University, Wroclaw, Poland

Adv Interv Cardiol 2021; 17, 1 (63): 122–123

DOI: https://doi.org/10.5114/aic.2021.104781

Online publish date: 2021/03/27

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AMA

Kübler P, Onisk G, Rachwalik M, Przybylski R, Reczuch K, Protasiewicz M. Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2021;17(1):122-123. doi:10.5114/aic.2021.104781.

APA

Kübler, P., Onisk, G., Rachwalik, M., Przybylski, R., Reczuch, K.,  & Protasiewicz, M. (2021). Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 17(1), 122-123. https://doi.org/10.5114/aic.2021.104781

Chicago

Kübler, Piotr, Grzegorz Onisk, Maciej Rachwalik, Roman Przybylski, Krzysztof Reczuch,  and Marcin Protasiewicz. 2021. "Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 17 (1): 122-123. doi:10.5114/aic.2021.104781.

Harvard

Kübler, P., Onisk, G., Rachwalik, M., Przybylski, R., Reczuch, K.,  and Protasiewicz, M. (2021). Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 17(1), pp.122-123. https://doi.org/10.5114/aic.2021.104781

MLA

Kübler, Piotr et al. "Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 17, no. 1, 2021, pp. 122-123. doi:10.5114/aic.2021.104781.

Vancouver

Kübler P, Onisk G, Rachwalik M, Przybylski R, Reczuch K, Protasiewicz M. Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2021;17(1):122-123. doi:10.5114/aic.2021.104781.

We present a case of a 74-year old woman with a history of diabetes, hypertension, carotid endarterectomy and stenting of iliac arteries because of peripheral artery disease (PAD), admitted with the recognition of non ST-segment elevation myocardial infarction. Immediate coronary angiography revealed multivessel disease with critical calcified left main (LM) stenosis (Figure 1 A). Additionally, tight aortic stenosis (AS) with reduced left ventricle ejection fraction (LVEF 40%) was diagnosed. Unfortunately, after transfer to the intensive care unit pulmonary oedema occurred, successfully treated with pharmacotherapy. An urgent heart team meeting was held and the patient was disqualified from open-heart surgery because of comorbidities and high risk (EuroSCORE II – 17%). We decided to perform a hybrid procedure, including one stage balloon aortic valvuloplasty (BAV), percutaneous coronary intervention (PCI) and finally transcatheter aortic valve implantation (TAVI). Moreover, computed tomography revealed highly calcified aortic annulus and due to PAD only an alternative approach for TAVI was possible (Figure 1 B corner).

Hybrid treatment of a tight aortic stenosis with critical calcified left main disease in a patient with poor left ventricular function

Piotr Kübler 1 , Grzegorz Onisk 1 , Maciej Rachwalik 2 , Roman Przybylski 3 , Krzysztof Reczuch 1 , Marcin Protasiewicz 4

Piotr Kübler

¹

,

Grzegorz Onisk

¹

,

Maciej Rachwalik

²

,

Roman Przybylski

³

,

Krzysztof Reczuch

¹

,

Marcin Protasiewicz

⁴