Background: ST elevation myocardial infarction (STEMI) has traditionally been a relative contraindication for the utilization of rotational atherectomy (RA). However, in severely calcified lesions, RA may be necessary to facilitate stent delivery.
Case Summary: Three patients who present with STEMI are found to have severely calcified lesions on intravascular ultrasound.
Right ventricular (RV) shock, classically characterized by elevated central venous pressure (CVP) with normal to low pulmonary artery (PA) and pulmonary capillary wedge pressures (PCWP), remains a significant cause of morbidity and mortality worldwide if left untreated. Therapies for the treatment of RV shock range from medical management to durable or percutaneous mechanical circulatory support (MCS). A unique MCS device, a percutaneous right ventricular assist device (pRVAD), approved for use by the Food and Drug Administration (FDA) in 2014, works by temporarily off-loading the RV through a single, dual lumen catheter with extracorporeal mechanical support and is capable of shunting blood from the right atrium (RA) to the main PA.
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