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  • ISSN: 2333-6676
    Volume 4, Issue 8
    Case Report
    Katsuhiko Takenaka and Yoshinobu Murasato*
    We encountered a case of an iatrogenic intra-stent coronary dissection at the guiding catheter engagement in 6-month follow-up angiography after a biolimus-eluting stent implantation in the left main coronary artery (LMCA). The optical coherence tomography revealed peeling of the thin neointima inside the stent and thrombus formation. We made a reentry through the dissected lumen with the guide wire and dilated with balloon, which provided sufficient lumen and completion of the bail-out without additional stenting. Since the neointima is immature and fragile, we should take care for the catheter engagement to the LMCA previously treated with the drug-eluting stent.
    Julia Seeger, Wolfgang Rottbauer, and Jochen Wohrle*
    Transcatheter aortic valve implantation (TAVI) in severe aortic stenosis is a well-established and safe therapeutic option in patients at high and intermediate surgical risk. Para valvular aortic regurgitation after TAVI has been identified as a negative prognostic factor. We report the first case, to our knowledge, demonstrating a time-dependent reduction of para valvular aortic regurgitation with the second generation Edwards Sapien 3 valve due to outer skirt adaptation. In our patient who received a second generation Edwards Sapien 3 aortic valve by transfemoral approach, initial aortography post implantation demonstrated mild to moderate aortic regurgitation. Repeat aortography 5 minutes after valve implantation showed complete elimination of aortic regurgitation without post dilation. This case demonstrates a delayed reduction of aortic regurgitation due to outer skirt adaptation with the Edwards Sapien 3 valve reducing the need for post-dilation. With the Edwards Sapien 3 post dilation should not be performed immediately after valve implantation in case of residual aortic regurgitation.
    Anil M Podhar, Jivtesh S Pahwa*, Devendra V Patil and Ankur Phatarpekar
    Percutaneous device closure of perimembranous ventricular septal defects (pm VSD) has shown a lot of progress and is considered a feasible alternative to intra cardiac surgery. Transcatheter device closure remains controversial for pm VSDs secondary to the risk of heart block [1]. Ante grade closure of pmVSD using an arteriovenous (AV) wire loop as part of the closure is still the norm world over [2]. We have been practicing retrograde arterial closure of pmVSDs by an off-label use of the Amplatzer duct occluder II (ADO II) device (St. Jude Medical, St. Paul, Minnesota) at our centre for defects = 6mm through femoral access. We report first in the world single access trancatheter closure of a 4.5mm pmVSD in a 16-years-old male with an ADO II device via right transradial route.
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