How should I treat a patient with idiopathic thrombocytopaenic purpura presenting with ST-elevation myocardial infarction?
04 Jan 2018
A 56-year-old woman presented with severe central chest pain associated with shortness of breath. She was known to have idiopathic thrombocytopaenic purpura for 25 years. Her initial electrocardiogram demonstrated sinus rhythm with a heart rate of 70 beats per minute and ST-segment elevation in the inferolateral leads…
How should I treat unprotected LM stenosis in a patient with ACS who develops a severe contrast-induced nephropathy after coronary angiography?
06 Dec 2017
A 75-year-old woman after coronary bypass grafting (LIMA to LAD and SVG to RCA) and severe comorbidities was referred to the hospital due to an acute coronary syndrome. Coronary angiography revealed left main complex stenosis and chronic occlusion of LIMA graft…
How should I treat a recurrent hemolysis after transcatheter closure of mitral paravalvular leak?
22 Nov 2017
A 73-year-old woman developed two symptomatic major mitral paravalvular leaks 3 years after bioprosthetic mitral valve replacement. Two percutaneous transcatheter procedures were performed. Despite favourable immediate ultrasound control, a persistent hemolysis required red blood cell transfusions...
How should I treat an ambiguous LAD lesion with discrepancy between SPECT perfusion defect and FFR measurement?
02 Nov 2017
A 62-year-old male was admitted, with chest pain at rest and elevated troponins. A cardiac magnetic resonance showed signs of a recent myocardial infarction which was confirmed by OCT showing a ruptured plaque…
How should I treat an embolised undeployed stent?
03 Oct 2017
A 51-year old man with crescendo angina in background of previous angioplasty to left anterior descending artery and right coronary artery. Coronary angiography demonstrated patent stents, but tight lesion in the distal right coronary artery.
How should I treat a small, failing surgical bioprosthesis in a high surgical risk patient?
14 Sep 2017
A 77-year-old female who underwent surgical aortic valve replacement with a 21mm Mosaic bioprosthesis 13 years prior presented with worsening dyspnea on exertion. The patient was considered high surgical risk, so surgical valve replacement as well as valve-in-valve transcatheter aortic valve implantation were discussed as a treatment options.
How should I treat a patient with severe aortic valve stenosis with highly impaired left ventricular function and concomitant coronary heart disease?
07 Aug 2017
A complex and challenging case of a 71 year-old male with severe bicuspid aortic stenosis (with moderate regurgitation) and concomitant coronary artery disease and severe left ventricle dysfunction...
How should I treat severe aortic stenosis, severe calcific triple vessel coronary disease and high surgical risk?
11 Jul 2017
A high risk surgical patient with severe bilateral saphenous vein varicosities and previous endovascular repair for infra-renal aortic aneurysm presents with crescendo angina and breathlessness…
How should I treat edge restenosis lesion after implantation of an everolimus-eluting metallic stent?
19 May 2017
A 60-year-old male presented with newly developed exertional chest pain. He had undergone percutaneous coronary intervention with a drug-eluting stent (DES) in the mid left anterior descending (LAD) artery at another hospital two years ago...
How should I treat renal artery in-stent restenosis and stent fracture after endovascular abdominal aortic aneurysm repair?
30 Apr 2017
A 68-year-old man with a history of prior endovascular abdominal aortic aneurysm repair, with recurrent flash pulmonary oedema and renal artery revascularisation including redo renal artery interventions for in-stent restenosis, presented with renal failure, severe uncontrolled high blood pressure and left renal stent fracture. The patient was prepared for a third renal revascularisation procedure.