Abdelhakim Allali1, Mohamed El-Mawardy1, Bettina Schwarz1, Takao Sato1, Volker Geist1, Ralph Toelg1, Gert Richardt1, Mohamed Abdel-Wahab2. 1. Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lübeck and Hamburg, Bad Segeberg, Germany. 2. Heart Center, Segeberger Kliniken GmbH, Academic Teaching Hospital for the Universities of Kiel, Lübeck and Hamburg, Bad Segeberg, Germany. Electronic address: mohamed.abdel-wahab@segebergerkliniken.de.
Abstract
OBJECTIVES: Percutaneous coronary intervention (PCI) after transcatheter aortic valve implantation (TAVI) can become technically challenging after implantation of the self-expanding Medtronic CoreValve (MCV) device, which completely covers the aortic root. The aim of this study was to report on the incidence, feasibility and outcome of PCI after TAVI with the MCV device. METHODS: Between 2007 and 2014, all patients subjected to PCI after MCV implantation in a single-center institutional TAVI database were retrospectively identified. Clinical, angiographic and procedural characteristics were reviewed and analyzed. RESULTS: We identified a total of 17 patients (5.7%) treated with 24 PCI procedures for 29 lesions at a median of 17.7months (range 1-72) after MCV implantation. The mean age was 79.7±6.8years and the mean logistic EuroSCORE was 30.3%±18.9%. Nine procedures were performed for patients with acute coronary syndrome. 89.6% of the treated lesions were of type B2/C and 79.3% were de novo ones. A median of one guiding catheter was necessary to intubate the target coronary ostium (range 1-10) and 95% of the lesions on the left coronary artery were treated through a Judkins catheter. In one primary PCI for STEMI the intubation of the right coronary ostium was not successful. Final procedural success was obtained in 95.8%, and peri-procedural death occurred in one patient. CONCLUSIONS: The need for PCI after MCV is not uncommon and is mostly related to coronary artery disease progression. PCI after MCV is usually feasible and safe, but coronary intubation in an emergency setting can be challenging.
OBJECTIVES: Percutaneous coronary intervention (PCI) after transcatheter aortic valve implantation (TAVI) can become technically challenging after implantation of the self-expanding Medtronic CoreValve (MCV) device, which completely covers the aortic root. The aim of this study was to report on the incidence, feasibility and outcome of PCI after TAVI with the MCV device. METHODS: Between 2007 and 2014, all patients subjected to PCI after MCV implantation in a single-center institutional TAVI database were retrospectively identified. Clinical, angiographic and procedural characteristics were reviewed and analyzed. RESULTS: We identified a total of 17 patients (5.7%) treated with 24 PCI procedures for 29 lesions at a median of 17.7months (range 1-72) after MCV implantation. The mean age was 79.7±6.8years and the mean logistic EuroSCORE was 30.3%±18.9%. Nine procedures were performed for patients with acute coronary syndrome. 89.6% of the treated lesions were of type B2/C and 79.3% were de novo ones. A median of one guiding catheter was necessary to intubate the target coronary ostium (range 1-10) and 95% of the lesions on the left coronary artery were treated through a Judkins catheter. In one primary PCI for STEMI the intubation of the right coronary ostium was not successful. Final procedural success was obtained in 95.8%, and peri-procedural death occurred in one patient. CONCLUSIONS: The need for PCI after MCV is not uncommon and is mostly related to coronary artery disease progression. PCI after MCV is usually feasible and safe, but coronary intubation in an emergency setting can be challenging.
Authors: Piotr Chodór; Krzysztof Wilczek; Roman Przybylski; Jerzy Nożyński; Łukasz Włoch; Zbigniew Kalarus Journal: Postepy Kardiol Interwencyjnej Date: 2019-09-18 Impact factor: 1.426
Authors: Nils Perrin; Amir Fassa; Antoine Baroz; Caroline Frangos; Stephane Mock; Angela Frei; Murat Cimci; Sophie Degrauwe; Marco Roffi; Juan Fernando Iglesias; Stephane Noble Journal: Cardiol J Date: 2020-05-21 Impact factor: 2.737