Abstract

Case: An 81-year-old man was referred to this institution with New York Heart Association Class III dyspnoea. Echocardiography revealed severe aortic stenosis with normal left ventricular function. Coronary angiography revealed a heavily calcified, severe distal left main coronary artery (LMCA) stenosis, which did not extend into the left anterior descending (LAD) or left circumflex artery (LCx). Femoral access was contraindicated, due to the presence of an infrarenal abdominal aortic aneurysm. Percutaneous aortic balloon valvuloplasty and coronary intervention were subsequently performed via 9-Fr sheath in the right brachial artery accessed through surgical cutdown.

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