Rota Ablation - When There is No Other Option. A Complex Case of 86 Years Old Male with Multiple Comorbids Presenting With Stemi.

Publication/Presentation Date

1-1-2023

Abstract

The aim of this report is to explore the direct and long-term outcome in a high risk patient who was treated with rotational atherectomy (RA) to assist the placement of drug eluting stents in heavily calcified lesions. The patient presented with acute STEMI and had severely calcified Left main stem (LMS) disease, requiring plaque modification before coronary angioplasty and stent implantation. As the patient was elderly, with multiple comorbids including a number of coronary interventions, a decision of conservative management was made. Patient then re-presented with typical chest pain and pulmonary edema. A Heart Team meeting was called and high risk decision of RA to LMS was taken. His percutaneous transluminal coronary angioplasty (PTCA) to LM and LAD was planned. LMS to LAD was rotablated with 1.75 burr and PTCA with 3.5 NC at 20 Atm. During the procedure, patient developed flash pulmonary edema. In post-operative care, his renal functions deteriorated and nephrology was taken on board. After multiple sessions of hemodialysis, patient was clinically improved and stabilized. The report highlights the expertise required in RA of a complex LMS disease and judicious post-procedure care which resulted in significant reduction of morbidity, mortality and frequent hospitalizations of the patient.

Volume

13

Issue

1

First Page

73

Last Page

76

ISSN

2000-9666

Disciplines

Medicine and Health Sciences

PubMedID

36817305

Department(s)

Fellows and Residents

Document Type

Article

Link to Full Text

Share

COinS