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Stenting of the unprotected left main coronary artery in patients with severe aortic stenosis prior to percutaneous valve interventions.
- Source :
-
Cardiovascular revascularization medicine : including molecular interventions [Cardiovasc Revasc Med] 2012 Mar-Apr; Vol. 13 (2), pp. 90-4. Date of Electronic Publication: 2012 Jan 30. - Publication Year :
- 2012
-
Abstract
- Aims: High-risk patients with severe aortic stenosis (AS) who are candidates for transcatheter valve implantation (TAVI) or balloon aortic valvuloplasty (BAV) may additionally require revascularization of the unprotected left main coronary artery (UPLM). We aimed to assess the feasibility and procedural safety of UPLM stenting in such patients.<br />Methods and Results: Ten cases of UPLM stenting prior to BAV or TAVI at three medical centers over a 2-year period were identified. Mean age was 84±4 years, aortic valve area was 0.70±0.12 cm(2), left ventricular ejection fraction was 58%±3%, and logistic EuroScore was 32±17. Intraaortic balloon counterpulsation was used in three patients. A single stent was used in seven patients, and two stents were used in three patients. One patient received a bare-metal stent, and the others received drug-eluting stents. No procedural complications occurred, and the patients were hemodynamically stable. Three patients subsequently underwent BAV, and seven underwent TAVI. During 6 months of follow-up, two patients died: one due to AS restenosis 6 months after BAV and one due to vascular complications 18 days after TAVI (34 days after UPLM stenting).<br />Conclusions: Stenting of the UPLM in patients with severe AS prior to percutaneous valve intervention seems feasible and safe. This approach may enable more patients to achieve comprehensive percutaneous therapy for severe coronary and valvular disease.<br /> (Copyright © 2012 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Aged, 80 and over
Aortic Valve Stenosis complications
Aortic Valve Stenosis diagnostic imaging
Coronary Angiography
Coronary Artery Disease complications
Coronary Artery Disease diagnostic imaging
Female
Follow-Up Studies
Humans
Severity of Illness Index
Time Factors
Tomography, X-Ray Computed
Aortic Valve Stenosis therapy
Catheterization
Coronary Artery Bypass methods
Coronary Artery Disease surgery
Coronary Vessels surgery
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1878-0938
- Volume :
- 13
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Cardiovascular revascularization medicine : including molecular interventions
- Publication Type :
- Academic Journal
- Accession number :
- 22296780
- Full Text :
- https://doi.org/10.1016/j.carrev.2011.12.005