Lots of interesting abstracts and cases were submitted for TCTAP & AP VALVES 2020 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don¡¯t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!
* The E-Science Station is well-optimized for PC.
We highly recommend you use a desktop computer or laptop to browse E-posters.
CASE20191031_018
| CORONARY - Chronic Total Occlusion | |
| Ipsilateral Retrograde Septal-Septal Strategies in Left Anterior Descending Recanalization | |
| Anatolii Larionov1 | |
| Clinics of the Samara State Medical University, Russian Federation1, | |
|
[Clinical Information]
- Patient initials or identifier number:
Patient H.
-Relevant clinical history and physical exam:
Patient H. 59 years old, Male, suffered within three years from Angina with mild exertion Class 3.
-Relevant test results prior to catheterization:
Echocardioscopy: EF - 61%, Hypokinesia of anteroseptal and apical segments
- Relevant catheterization findings:
Short LAD occlusion in middle segment with ambiguous proximal cap and epicardial collateral from DB to LAD
 MOVIE-0001.wmv MOVIE-0002.wmv |
|
|
[Interventional Management]
- Procedural step:
The patient had short LAD occlusion in the middle segment with ambiguous proximal cap and unclear distal cap. He had also well-developed epicardial collateral from 1st DB to LAD. The option could be IVUS-guided proximal cap penetration, but it was unavailable at that time. The patient didn't have visible septal collaterals, but in spite of this fact I decided to start from retrograde from the first septal branch. Sion blue wire with Corsair successfully crossed septal loop and achieved the distal cap of occlusion near bifurcation of septal branch and LAD. Then Sion blue wire was exchanged to Gaia second wire which crossed occlusion due to pure retrograde technique and Corsair was pushed toward the proximal LAD and then was moved backwards. Chanel dilatation allowed Fielder XT-R to place antegrade in distal LAD. After predilatation and implantation of two DES in LAD, kissing-balloon dilatation and POT were performed. Finally, control examination showed patent LAD and DB with short ostial dissection in DB, also the small fistula from septal branch to left ventricle was observed.
MOVIE-0005.wmv MOVIE-0009.wmv MOVIE-0014.wmv- Case Summary:
Ipsilateral septal-septal techniques are well known and could be performed even in cases without visible connections.Retrograde approach facilitates recanalization in cases of ambiguous proximal cap and helps to avoid subintimal techniques which are not appropriate in LAD lesions.Dear committee, I want you to allow me to prepare presentation with comparison of three different cases in LAD occlusions with ipsilateral septal-septal strategy.
|
|
0