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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!

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CASE20200924_002

Complications - Complications
Nightmare in Cath-lab - Patience is the Real Player
Mahmood Hasan Khan, Shahab Uddin Talukder3, Aqm Reza4
, Evercare Hospital Dhaka, Bangladesh3, Apollo Hospitals Dhaka, Bangladesh4,
[Clinical Information] - Patient initials or identifier number: KAA -Relevant clinical history and physical exam: ´Mr. KAA ´Age: 61 years ´Gender: Male ´Risk Factors: Diabetes, Hypertension ´Admitted as a case of Acute Inferior ST Elevated - ACS. ´ECG: Acute MI (Inferior) with Anterior Ischaemia ´Echo: RWMA (+) with LVEF: 30% & WMSI: 1.41 -Relevant test results prior to catheterization: Hb--> 12.3 gm/dl TLC--> 9600/ cmm Na--> 135 mmol/L K--> 4.1 mmol/L - Relevant catheterization findings: Ø Triple Vessel CAD. ØRCA:100% occluded from proximal segment. ØLAD:70-80% multiple lesions at proximal- mid segments. Ø LCx:  60% concentric plaque at proximal segment. Ø Recommended for Primary PCI to RCA & Stage PCI to LAD
[Interventional Management] - Procedural step: ´Route Used: Left  Femoral ´Guide Catheter: JR6F ´Vascular Access Sheath: 7F & 14F ´Guide Wires:  Teremu 0.035“ x 260 cm Exchange wire                                 Floppy ´Andra 20 mm Snare Left femoral access was done. A JR 6F guide catheter was used with 7F & 14F vascular access sheaths were taken. The broken sheath part was accessed with Teremu 0.035" x 260 cm exchange wire & Floppy wires. Then a snare was introduced through the sheath & the broken sheath was caught by the snare and it was taken out from the body slowly & carefully. The total procedure was uneventful. - Case Summary: ´Complications are the lessons for the interventionists. ´Complication management is a great challenge. ´Planning is essential. ´Perseverance is mandatory. ´Need to have all kinds of hardwires in the shelve. ´Last but not the least patient must get the priority above all.

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