20 May 2025
Complex PCI in a TAVI patient - LIVE case
Calcified distal left main bifurcation PCI with a TAP technique after TAVI
Operators:
B. Farah, N. Dumonteil
Procedural Analyst:
C. Cook
Summary
An 84-year-old patient with a history of ischemic stroke in 2017, hypertension, diabetes, dyslipidemia, and a preserved LV function (63 %) presented with a severe symptomatic aortic stenosis. The coronary angiography revealed a severe and calcified stenosis of the distal left main.
Operators implanted an Edwards Sapien and, in a staged procedure, they treated the distal left main with a TAP technique after preparing the lesion with an IVUS-guided rotablator.
LIVE Educational Case from Clinique Pasteur - Toulouse, France
Navigate the video by moving your mouse over the chapter icon in the toolbar
Key moments
- 24:25–28:04, 53:01–55:20, 1:21:57–1:24:05 - Step-by-step IVUS guidance
- 28:56-32:54 - Rotablator
- 1:05:48-1:15:50 - Step-by-step TAP technique
Keywords: distal left main stenosis - Rotablator - IVUS - TAP technique
Learning Objectives
- To discuss the management of TAVI candidates presenting with complex coronary artery disease
- To discuss PCI techniques for true distal left main bifurcation lesion
- To highlight the value of intracoronary imaging guidance for complex PCI
