Staged Percutaneous Coronary Intervention with Rotational Atherectomy or Bypass Surgery in Chronic Hemodialysis and Severely Calcified Left Main True Bifurcation Lesion: A Case Report and Literature Review

Autor: Kazuhiro Dan, Akira Shinoda, Hector M Garcia-Garcia
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Zdroj: Clinical Medicine Insights: Cardiology, Vol 14 (2020)
Druh dokumentu: article
ISSN: 1179-5468
11795468
DOI: 10.1177/1179546820951798
Popis: Previous observational studies and meta-analyses reported that the optimal strategy of coronary revascularization (percutaneous coronary intervention [PCI] and bypass surgery) for anatomically complex coronary artery lesions in the chronic hemodialysis setting is still controversial because the long-term outcomes were superior with coronary artery bypass grafting, especially with regard to repeat revascularization; however, short-term mortality with PCI was significantly lower because it is less invasive. Moreover, no guidelines show a strategy for this setting. We report the case of a patient with chronic dialysis and calcified left main true bifurcation lesion who underwent staged PCI with rotational atherectomy and minimally invasive direct coronary artery bypass for in-stent restenosis who died of non-occlusive mesenteric ischemia.
Databáze: Directory of Open Access Journals
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