{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T17:00:53Z","timestamp":1780419653459,"version":"3.54.1"},"reference-count":11,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T00:00:00Z","timestamp":1638835200000},"content-version":"vor","delay-in-days":6,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Patients undergoing transcatheter aortic valve replacement (TAVR) usually have multiple comorbidities, such as severely impaired left ventricular function (LVF) and heavily calcified coronary lesions. When they undergo pre-TAVR high-risk percutaneous coronary interventions (HR-PCIs) for severely calcified left main (LM) lesions, potential life-threatening intra-procedural complications associated with the different techniques available to treat calcified lesions can arise. In this setting, mechanical circulatory support proves its usefulness. However, the choice of device can be troublesome.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case summary<\/jats:title>\n                  <jats:p>We report two clinical scenarios of intravascular lithotripsy (IVL) for the treatment of heavily calcified LM coronary lesions, wherein peripheral veno-arterial extracorporeal membrane oxygenation (VA-ECMO), alone or combined with an intra-aortic balloon pump (IABP), were used as an upfront strategy to support the procedure. The use of these techniques was particularly effective during multi-vessel HR-PCIs and TAVR, and no complications occurred, which suggested their safety.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion<\/jats:title>\n                  <jats:p>These cases provide multiple insights into the strategy of using IVL + VA-ECMO, alone or with IABP, to treat heavily calcified LM coronary lesions in patients with severely compromised LVF undergoing TAVR. IVL safely and effectively overcame shortcomings related to other plaque ablation techniques, and VA-ECMO proved to be effective when facing the combination of high-risk coronary and valve interventions.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ehjcr\/ytab498","type":"journal-article","created":{"date-parts":[[2021,12,7]],"date-time":"2021-12-07T18:23:32Z","timestamp":1638901412000},"source":"Crossref","is-referenced-by-count":9,"title":["Mechanical circulatory support and intravascular lithotripsy in high-risk patients undergoing percutaneous coronary intervention and transcatheter aortic valve replacement: a case series"],"prefix":"10.1093","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3445-0865","authenticated-orcid":false,"given":"Alfredo","family":"Marchese","sequence":"first","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Tarantini","sequence":"additional","affiliation":[{"name":"Department of Cardiac, Thoracic and Vascular Sciences, University of Padua, Via Giustiniani, 2. 35128 Padova, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6009-6815","authenticated-orcid":false,"given":"Antonio","family":"Tito","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vito","family":"Margari","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Resta","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilir","family":"Dhojniku","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2261-7098","authenticated-orcid":false,"given":"Domenico","family":"Paparella","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Speziale","sequence":"additional","affiliation":[{"name":"Ospedale Santa Maria, GVM Care & Research, Via Antonio De Ferrariis 22, 70124 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,12,7]]},"reference":[{"key":"2021121919112864000_ytab498-B1","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1093\/eurheartj\/ehx391","article-title":"2017 ESC\/EACTS Guidelines for the management of valvular heart disease","volume":"38","author":"Baumgartner","year":"2017","journal-title":"Eur Heart J"},{"key":"2021121919112864000_ytab498-B2","doi-asserted-by":"crossref","first-page":"1695","DOI":"10.1056\/NEJMoa1814052","article-title":"Transcatheter aortic-valve replacement with a balloon-expandable valve in low-risk patients","volume":"380","author":"Mack","year":"2019","journal-title":"N Engl J Med"},{"key":"2021121919112864000_ytab498-B3","doi-asserted-by":"crossref","first-page":"1057","DOI":"10.1002\/ccd.25277","article-title":"Optimizing rotational atherectomy in high-risk percutaneous coronary interventions: insights from the PROTECT II study","volume":"83","author":"Cohen","year":"2014","journal-title":"Catheter Cardiovasc Interv"},{"key":"2021121919112864000_ytab498-B4","doi-asserted-by":"crossref","first-page":"2635","DOI":"10.1016\/j.jacc.2020.09.603","article-title":"Intravascular lithotripsy for treatment of severely calcified coronary artery disease. The Disrupt III study","volume":"76","author":"Hill","year":"2020","journal-title":"J Am Coll Cardiol"},{"key":"2021121919112864000_ytab498-B5","first-page":"46","article-title":"Intracoronary lithotripsy in percutaneous treatment of calcific left main coronary stenosis","volume":"1","author":"Salazar","year":"2019","journal-title":"J Am Coll Cardiol Case Rep"},{"key":"2021121919112864000_ytab498-B6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1093\/eurheartj\/ehy394","article-title":"2018 ESC\/EACTS Guidelines on myocardial revascularization","volume":"40","author":"Neumann","year":"2019","journal-title":"Eur Heart J"},{"key":"2021121919112864000_ytab498-B7","first-page":"456","article-title":"Outcomes of extracorporeal membrane oxygenation support for complex high-risk elective percutaneous coronary interventions: a single-centre experience and review of the literature","volume":"30","author":"Shaukat","year":"2018","journal-title":"J Invasive Cardiol"},{"key":"2021121919112864000_ytab498-B8","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1007\/s12471-019-01350-8","article-title":"Prophylactic veno-arterial extracorporeal membrane oxygenation in patients undergoing high-risk percutaneous coronary intervention","volume":"28","author":"van den Brink","year":"2020","journal-title":"Neth Heart J"},{"key":"2021121919112864000_ytab498-B9","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1093\/ejcts\/ezy304","article-title":"Effect of an intra-aortic balloon pump with venoarterial extracorporeal membrane oxygenation on mortality of patients with cardiogenic shock: a systematic review and meta-analysis","volume":"55","author":"Li","year":"2019","journal-title":"Eur J Cardiothorac Surg"},{"key":"2021121919112864000_ytab498-B10","doi-asserted-by":"crossref","first-page":"1974","DOI":"10.1097\/CCM.0000000000001828","article-title":"The effect of intraaortic balloon pumping under venoarterial extracorporeal membrane oxygenation on mortality of cardiogenic patients: an analysis using a nationwide inpatient database","volume":"44","author":"Aso","year":"2016","journal-title":"Crit Care Med"},{"key":"2021121919112864000_ytab498-B11","doi-asserted-by":"crossref","first-page":"357","DOI":"10.1002\/ccd.28375","article-title":"Hemodynamic support with Impella ventricular assist device in patients undergoing TAVI: a single center experience","volume":"95","author":"Almalla","year":"2020","journal-title":"Catheter Cardiovasc Interv"}],"container-title":["European Heart Journal - Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ehjcr\/advance-article-pdf\/doi\/10.1093\/ehjcr\/ytab498\/41624659\/ytab498.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/12\/ytab498\/41821602\/ytab498.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ehjcr\/article-pdf\/5\/12\/ytab498\/41821602\/ytab498.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,19]],"date-time":"2021-12-19T19:11:51Z","timestamp":1639941111000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ehjcr\/article\/doi\/10.1093\/ehjcr\/ytab498\/6454951"}},"subtitle":[],"editor":[{"given":"Mohamed","family":"Farag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Lavanya","family":"Athithan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Ross","family":"Thomson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]},{"given":"Nida","family":"Ahmed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2021,12,1]]},"references-count":11,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2021,12,3]]}},"URL":"https:\/\/doi.org\/10.1093\/ehjcr\/ytab498","relation":{},"ISSN":["2514-2119"],"issn-type":[{"value":"2514-2119","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,12,1]]},"published":{"date-parts":[[2021,12,1]]},"article-number":"ytab498"}}