ArticleEuropean heart journal. Case reports2026
New sheathless supra-aortic pulsatile mechanical support via subclavian access for combined protected percutaneous coronary intervention and transcatheter aortic valve implantation in hostile vascular disease: a case report.
Article in European heart journal. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: The combination of severe aortic stenosis, complex multivessel coronary artery disease and severe left ventricular systolic dysfunction represents a procedural challenge in which coronary revascularization and transcatheter aortic valve implantation (TAVI) must be carefully integrated. Mechanical circulatory support (MCS) indication and selection are crucial when extensive peripheral arterial disease limits conventional large-bore access and when interaction with valve deployment must be avoided. Case summary: An 84-year-old man was admitted to our intensive cardiac care unit with acute decompensated heart failure. Echocardiography showed severely reduced left ventricular ejection fraction (15%) and severe aortic stenosis (mean gradient 41 mmHg; aortic valve area by velocity-time integral 0.45 cm Conclusion: The new sheathless pulsatile MCS provides haemodynamic stabilization, reduces access profile compared with the previous generation of the device and enables integration of complex PCI and transfemoral TAVI in patients with hostile vascular anatomy.
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