Emergent Percutaneous Rotational Atherectomy to Bailout Surgical Transapical Aortic Valve Implantation: A Successful Case of Heart Team Turnaround

Abstract Transcatheter aortic valve implantation (TAVI) is an established treatment for severe aortic stenosis (AS) in patients with elevated surgical risk. Concomitant coronary artery disease affects 55-70% of patients with severe AS. Percutaneous coronary intervention in patients with TAVI can be challenging. We report a case of acute coronary obstruction immediately following transapical TAVI deployment requiring emergent rotational atherectomy.

经导管主动脉瓣植入术（Transcatheter aortic valve implantation, TAVI）是针对外科手术风险升高的重度主动脉瓣狭窄（aortic stenosis, AS）患者的成熟治疗方案。约55%~70%的重度AS患者合并冠状动脉疾病。针对接受TAVI治疗的患者实施经皮冠状动脉介入治疗颇具挑战性。本文报告1例经心尖TAVI植入术后即刻出现急性冠状动脉阻塞，需紧急行冠状动脉旋磨术（rotational atherectomy）的病例。