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BackgroundFollowing transcatheter aortic valve replacement, acute coronary obstruction is infrequent but potentially life-threatening, while delayed coronary obstruction is even more uncommon.Case summaryA 69-year-old male underwent TAVR and subsequently developed an acute obstruction in the left main coronary artery.
A recent study found noninvasive ultrasound therapy could be a treatment option for some patients who cannot undergo surgical or transcatheter valve replacement.
Once stabilized, intravascular ultrasound showed significant thrombus and plaque in the LAD. Due to ongoing shock despite initial mechanical support, the patient was escalated to an Impella CP device after a transthoracic echo confirmed no left ventricle thrombus. This was treated with a drug-eluting stent, but TIMI 3 flow was not achieved.
ET Main Tent (Hall B1) Coronary Sinus Reducer for the Treatment of Refractory Angina: A Randomised, Placebo-controlled Trial (ORBITA-COSMIC) Transcatheter Aortic Valve Implantation Versus Surgical Aortic Valve Replacement in Patients at Low to Intermediate Risk: One Year Outcomes of the Randomized DEDICATE-DZHK6 Trial Effect of Alcohol-mediated Renal (..)
TAVR) or quality studies, and forecast case volumes and inventory/resource needs. Intelligent AI-driven Workflow ASCEND’s AI-driven image viewer, InView, provides an intelligent, highly effective solution for echo, vascular and cath reading and reporting.
Smith comment: This patient did not have a bedside ultrasound. Had one been done, it would have shown a feature that is apparent on this ultrasound (however, this patient's LV function would not be as good as in this clip): This is recorded with the LV on the right. In fact, bedside ultrasound might even find severe aortic stenosis.
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