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Pre‐emptive positioning of a coronary stent in the left anterior descending artery for left main protection: A prerequisite for transcatheter aortic valve‐in‐valve implantation for failing stentless bioprostheses?
Author(s) -
Chakravarty Tarun,
Jilaihawi Hasan,
Nakamura Mamoo,
Kashif Mohammad,
Kar Saibal,
Cheng Wen,
Makkar Raj
Publication year - 2013
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.25037
Subject(s) - medicine , cardiology , stent , occlusion , aortic valve replacement , aortic valve , artery , surgery , stenosis
Transcatheter aortic valve‐in‐valve (VIV) implantation in high‐risk patients with degenerative surgical bioprosthetic aortic valves is a novel application of transcatheter aortic valve replacement technology. Although transcatheter aortic VIV procedure is clinically effective in most patients, it is a more demanding procedure in terms of the technical aspects of procedural planning. VIV carries a higher risk of coronary occlusion which is associated with a higher rate of in‐hospital mortality. We hereby report a technique of pre‐emptive left main (LM) protection, by positioning a coronary stent in the proximal left anterior descending artery prior to VIV implantation. The patient treated was considered to be at an increased risk of LM occlusion as a result of the procedure. The technique was performed in anticipation of emergent bailout stenting of the LM. As predicted, the LM occluded during the procedure and LM protection facilitated the safe and effective treatment of an otherwise life‐threatening procedure. © 2013 Wiley Periodicals, Inc.