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Chordae Tendineae Rupture and Iatrogenic Severe Mitral Regurgitation Related to Impella

DOI: 10.4244/EIJ-D-19-00942

1. Section of Interventional Cardiology, MedStar Washington Hospital Center, Washington, DC, United States

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A 47-year-old man presented with witnessed out-of-hospital cardiac arrest at his wedding and anterior ST- elevation myocardial infarction. Initial blood pressure was 90/60 mmHg with pulse of 115 beats/minute. Coronary angiography showed 100% thrombotic occlusion of the proximal left anterior descending artery with Thrombolysis in Myocardial Infarction (TIMI)-0 flow, 90% disease in the proximal first diagonal, 80% disease in the small-caliber obtuse marginal-1, and 90% disease in the non-dominant mid right coronary artery (Figure 1A-C). Aspiration thrombectomy was performed with Pronto® LP Extraction Catheter (Teleflex, Inc., Wayne, Pennsylvania, USA), restoring sluggish flow. A 3.0x38 mm Xience (Abbott Vascular, Chicago, Illinois, USA) drug-eluting stent was deployed, establishing TIMI-3 flow.

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