title: Management of significant left main coronary disease before and after trans-apical transcatheter aortic valve replacement in a patient with severe and complex arterial disease.
abstract: We report the case of an 81-year-old woman with symptomatic severe aortic stenosis, extremely significant peripheral arterial disease, and obstructive coronary artery disease who underwent percutaneous coronary intervention via a transaxillary conduit immediately before a trans-apical transcatheter aortic valve replacement performed with a transfemoral device. After deployment of the transcatheter heart valve, there was a left main coronary obstruction and the patient required an emergent PCI. This multifaceted case clearly underlines the importance of a well functioning heart team including the interventional cardiologist, the cardiovascular surgeon, and the echocardiographer.
authors: Columbia University Medical Center, New York, New York; Cardiovascular Research Foundation, New York, New York.
authors: Jean-Michel
authors: JM
authors: Paradis
authors: Isaac
authors: I
authors: George
authors: Susheel
authors: S
authors: Kodali
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006328:Cardiac Catheterization; D023921:Coronary Stenosis / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D004630:Emergencies; D005260:Female; D005263:Femoral Artery; D019918:Heart Valve Prosthesis Implantation / Q000379:methods*; D006801:Humans; D010348:Patient Care Team; D062645:Percutaneous Coronary Intervention; D058729:Peripheral Arterial Disease / Q000150:complications / Q000175:diagnosis; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: left main coronary disease; peripheral vascular disease; valvular heart disease