title: No reflow leading to catastrophic hemodynamic collapse in a patient with severe aortic stenosis and its management.
abstract: We report a case of an 87-year-old female who underwent percutaneous coronary intervention (PCI) for non-ST elevation myocardial infarction while she was being worked up for transcatheter aortic valve procedure. Hemodynamic compromise occurred during the PCI, which could only be mitigated by doing a balloon aortic valvuloplasty and Impella™ insertion. This case report will help in preparedness for any untoward events in patients with aortic stenosis and undergoing percutaneous coronary intervention.
authors.affiliation: Division of Cardiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
authors.forename: Ravinder
authors.initials: R
authors.lastname: Singh Rao
authors.affiliation: Division of Cardiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
authors.forename: Robert L
authors.initials: RL
authors.lastname: Shapiro
authors.affiliation: Division of Cardiology, Washington University School of Medicine in St. Louis, St. Louis, Missouri.
authors.forename: John M
authors.initials: JM
authors.lastname: Lasala
mesh_terms: D000369:Aged, 80 and over; D001024:Aortic Valve Stenosis / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D063126:Balloon Valvuloplasty; D006328:Cardiac Catheterization / Q000295:instrumentation; D017023:Coronary Angiography; D004452:Echocardiography; D005260:Female; D006350:Heart Valve Prosthesis; D019918:Heart Valve Prosthesis Implantation / Q000295:instrumentation / Q000379:methods*; D006353:Heart-Assist Devices; D006439:Hemodynamics; D006801:Humans; D054318:No-Reflow Phenomenon / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D000072658:Non-ST Elevated Myocardial Infarction / Q000150:complications / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D062645:Percutaneous Coronary Intervention / Q000009:adverse effects*; D012720:Severity of Illness Index; D012769:Shock / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome
keywords: impella; no-reflow; valvuloplasty