One-stop PCI+TAVR intraoperative circulatory collapse and successful
rescue of 1 case report
Abstract
Background and Aim: We report a case of severe aortic stenosis
accompanied by severe aortic insufficiency complicated with coronary
heart disease who underwent one-stop PCI+TAVR intraoperative circulation
collapse and was successfully rescued. Case Summary:A 73-year-old male
patient with severe aortic stenosis with severe aortic insufficiency and
coronary heart disease underwent one-stop TAVR+PCI with the aid of
Cardiopulmonary bypass(CPB). PCI was successfully performed in the
patient, and a 2.5*33cm Nano coronary stent was implanted. No residual
stenosis was observed in angiography. During TAVR, A Venus-A L26mm
interventional valve was inserted, and the valve slid slightly downward
with poor position. Aortic root angiography showed A large amount of
regurgitation and A progressive decrease in blood pressure, which could
not be maintained even after the application of vasoactive drugs. Chest
compressions were performed, and the extracorporeal circulation machine
was opened to assist circulation. In the same way, A Venus-A L26mm
interventional valve was placed in the previous valve. Aortic root
angiography was performed without regurgitation. TEE examination showed
that the valve opened and closed well and the orifice velocity was
normal without regurgitation. After surgery, the patient returned to ICU
smoothly. Conclusion: One-stop PCI+TAVR is a reasonable method for the
treatment of aortic valve disease complicated with coronary heart
disease. Cardiopulmonary bypass (CPB) is an effective method to deal
with circulatory collapse in time.