Angioplasty Balloon Entrapped Fully Inflated and Detached Within the Left Main Coronary Artery
Abdel Rahman Omer1, Michael Bianco2, Aadil Lodhi2
1Robert Packer Hospital, Sayre, PA, United States of America; Geisinger Commonwealth School of Medicine, United States of America.
Insights
A challenging case of left main coronary stenting after TAVR involved a balloon that failed to deflate, leading to cardiogenic shock. Innovative techniques successfully managed the entrapped balloon, enabling stenting and uneventful recovery.
Area of Science:
- Interventional Cardiology
- Cardiovascular Surgery
- Medical Device Technology
Background:
- Transcatheter aortic valve replacement (TAVR) can pose risks for left main coronary artery (LMCA) complications.
- Threatened LMCA closure is a serious complication following TAVR, requiring urgent intervention.
Abstract:
Described is a complication of rescue left main coronary stenting due to threatened left main closure following a "valve in valve" TAVR procedure. Left main stent post dilatation with a NC Trek balloon was complicated by a failure to deflate the balloon. The patient spiraled into cardiogenic shock and was stabilized by an intra-aortic balloon pump. Attempts to withdraw the balloon resulted in shearing of the balloon off the shaft. Parallel wiring and sequential balloon dilatations allowed left main bifurcation stenting while crushing the inflated balloon underneath the stent's struts. Follow up of 13 months was uneventful. The management of entrapped inflated coronary balloon is reviewed.
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