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One-stop PCI+TAVR intraoperative circulatory collapse and successful rescue of 1 case report
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  • Hang Zhang,
  • Jinghui An,
  • SU Liu,
  • Qianli Ma,
  • Feng-wu Shi
Hang Zhang
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Jinghui An
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Feng-wu Shi
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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.