Cases in Interventional Cardiovascular Medicine: Read & Share cases

This section provides a selection of Read and Share clinical cases provided by experts in interventional cardiology. Your comments are welcome! Use this section to share YOUR experience and/or questions with your peers. Please log into your free My PCR account to read or make any comments or contributions.

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83 results

Treating severe restenosis of a 20-mm balloon-expanding valve after a transapical approach with a risk of coronary obstruction

05 Nov 2025

In this challenging redo TAVI case, an 87-year-old woman presented with severe bioprosthetic valve restenosis and advanced heart failure symptoms, eight years after a previous transapical implantation.

Her frailty, prior surgical approach, and complex anatomy—with low coronary heights and a stent frame extending beyond the sinotubular junction—posed...

Sasho Stanisavljevikj

Author

Sasho Stanisavljevikj
Rumman

Author

Abu Rumman
Jens Papenfuss

Author

Jens Papenfuss

Author

Christian Jacob
Alexander Staudt

Author

Alexander Staudt
Christian Fahje Klopsch

Author

Christian Fahje Klopsch
Treating severe restenosis of a 20-mm balloon-expanding valve after a transapical approach with a risk of coronary obstruction

Calcium nodule in circumflex ostium: a complex problem

31 Oct 2025

Analyse this case of an 83-year-old male patient, hypertensive, ex-smoker, with severe COPD and peripheral arterial disease with unstable angina. Coronary angiography revealed a severely calcified lesion in a complex anatomical area, making revascularisation a therapeutic challenge.

Jorge Perea

Author

Jorge Perea
Javier Suarez de Lezo

Author

Javier Suarez de Lezo
Soledad Ojeda

Author

Soledad Ojeda
Prof. Manuel Pan

Author

Manuel Pan
Calcium nodule in circumflex ostium: a complex problem

Large thrombus burden management in a young patient with inferior STEMI and multivessel disease

08 Oct 2025

A 51-year-old man with an inferior STEMI and multivessel disease was found to have a thrombotic sub-occlusion in the mid RCA. Angiography also revealed significant disease in the LAD. How would you manage this case?

Antonio Landi

Author

Antonio Landi
Andrea Milzi

Author

Andrea Milzi
Marco Valgimigli

Author

Marco Valgimigli
Large thrombus burden management in a young patient with inferior STEMI and multivessel disease

Sealing the risk: a case of left atrial appendage closure

15 Sep 2025

A 76-year-old woman with permanent atrial fibrillation, a history of breast cancer, and a recent diagnosis of an intestinal stromal tumour presents with a high thromboembolic and bleeding risk, making long-term anticoagulation unsafe. Cardiac CT reveals a challenging left atrial appendage anatomy. How would you treat this...

Sergio Berti

Author

Sergio Berti
Giovanni Benedetti

Author

Giovanni Benedetti
Luigi Emilio Pastormerlo

Author

Luigi Emilio Pastormerlo
Augusto Eposito

Author

Augusto Eposito
Marta Casula

Author

Marta Casula
Sealing the risk: a case of left atrial appendage closure

How should I treat this aortic stenosis with small anatomy, low coronary offset and extremely horizontal aorta

16 Jul 2025

An 81-year-old patient with symptomatic severe aortic stenosis, a 74° horizontal aorta, and critically low coronary height—a challenging mix that pushed the heart team to weigh all procedural options. Discover how detailed CT analysis, intra-procedural strategy, and step-by-step imaging assessments guided their approach. What would you...

Author

Birgid Gonska
How should I treat this aortic stenosis with small anatomy, low coronary offset and extremely horizontal aorta

How should I manage a patient with insufficient surgical closure of the left atrial appendage

26 Jun 2025

Incomplete surgical LAA closure: how would you proceed?
Despite prior closure with an Atriclip during CABG, transoesophageal echocardiography reveals a persistent LAA gap in a high-risk patient with recurrent bleeding.
Explore the clinical details, imaging, and treatment dilemmas—then share your management approach!

Thomas Stiermaier

Author

Thomas Stiermaier
How should I manage a patient with insufficient surgical closure of the left atrial appendage

When bleeding risk shapes your PCI strategy

05 Jun 2025

Managing ACS in a high-bleeding-risk patient is always a delicate balance. In this case, an 83-year-old with NSTEMI, advanced CKD, and a recent intracranial hemorrhage presented with a complex mid-to-distal LAD lesion. What would be your strategy?

Deborah J. Lee

Author

Deborah J. Lee
When bleeding risk shapes your PCI strategy

Primary tricuspid regurgitation: how can we avoid high-risk surgery?

08 Apr 2025

A 70-year-old male patient presents with severe dyspnea (NYHA III) and marked leg edema, alongside a complex medical history including hypertrophic cardiomyopathy, pulmonary hypertension, and liver fibrosis.

With invasive hemodynamic measurements indicating elevated pressures and reduced cardiac output, how would you approach the treatment of this patient,...

Philipp Bartko

Author

Philipp Bartko
Varius Dannenberg

Author

Varius Dannenberg
Primary tricuspid regurgitation: how can we avoid high-risk surgery?

Navigating LAA closure in retrobend chicken-wing anatomy

07 Mar 2025

A 76-year-old female patient with a history of atrial fibrillation and contraindication to long-term anticoagulation presents for left atrial appendage closure. However, preprocedural imaging reveals a challenging retrobend chicken-wing morphology. What is the best technique to optimize positioning and ensure safe, effective closure in this scenario?

Adel Aminian

Author

Adel Aminian
Xavier Freixa

Author

Xavier Freixa
Dr Philippe Garot

Author

Philippe Garot
Navigating LAA closure in retrobend chicken-wing anatomy

How should I treat a left main disease with multivessel diffuse CAD? Stenting only the necessary...

28 Feb 2025

A 71-year-old male patient with a clinicial history of hypertension, dyslipidemia and active smoking was admitted for NSTEMI.

Coronary angiography showed a left main (LM) stenosis involving the bifurcation and proximal parts of the left anterior descending (LAD) and left circumflex (LCx) arteries. Right coronary artery (RCA) showed a severe...

Eva Rumiz

Author

Eva Rumiz
How should I treat a left main disease with multivessel diffuse CAD? Stenting only the necessary