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Peer-reviewedCC BY-NC-ND 4.0JACC Case Reports

Subclavian VA-ECMO–Supported TAVR and Rotational Atherectomy in Cardiogenic Shock

  • Daisuke Fukamachi1
  • Hidesato Fujito1
  • Naoya Matsumoto1
  • Yasuo Okumura2
  1. 1Division of Cardiology, Department of Medicine, Nihon University Hospital, Chiyoda City, Tokyo, Japan
  2. 2Division of Cardiology, Department of Medicine, Nihon University School of Medicine, Itabashi City, Tokyo, Japan
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Abstract

Background: Severe aortic stenosis and critical coronary disease can coexist in cardiogenic shock, requiring individualized decisions regarding access, sequencing, and antithrombotic therapy.

Case Summary: A 72-year-old man with prior coronary artery bypass grafting developed progressive low-output heart failure with low-flow, low-gradient severe aortic stenosis and critical calcified native left anterior descending artery disease after left internal thoracic artery graft occlusion. Right common iliac artery occlusion limited conventional femoral arterial support. Subclavian venoarterial extracorporeal membrane oxygenation preserved left transfemoral access for transcatheter aortic valve replacement, which was followed by left radial rotational atherectomy–assisted left anterior descending percutaneous coronary intervention.

Discussion: This case illustrates individualized access planning and transcatheter aortic valve replacement-first sequencing to facilitate protected complex percutaneous coronary intervention and safe venoarterial extracorporeal membrane oxygenation weaning in cardiogenic shock.

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Cite

BibTeXRIS
BibTeX
@article{fukamachi2026subclavian,
  title = {{Subclavian VA-ECMO–Supported TAVR and Rotational Atherectomy in Cardiogenic Shock}},
  author = {Daisuke Fukamachi and Hidesato Fujito and Naoya Matsumoto and Yasuo Okumura},
  journal = {JACC Case Reports},
  year = {2026},
  month = aug,
  doi = {10.1016/j.jaccas.2026.110031},
  url = {https://doi.org/10.1016/j.jaccas.2026.110031},
  note = {CC BY-NC-ND 4.0},
}
RIS
TY  - JOUR
TI  - Subclavian VA-ECMO–Supported TAVR and Rotational Atherectomy in Cardiogenic Shock
AU  - Daisuke Fukamachi
AU  - Hidesato Fujito
AU  - Naoya Matsumoto
AU  - Yasuo Okumura
PY  - 2026
DA  - 2026/08/28
JO  - JACC Case Reports
DO  - 10.1016/j.jaccas.2026.110031
UR  - https://doi.org/10.1016/j.jaccas.2026.110031
AB  - Background: Severe aortic stenosis and critical coronary disease can coexist in cardiogenic shock, requiring individualized decisions regarding access, sequencing, and antithrombotic therapy.  Case Summary: A 72-year-old man with prior coronary artery bypass grafting developed progressive low-output heart failure with low-flow, low-gradient severe aortic stenosis and critical calcified native left anterior descending artery disease after left internal thoracic artery graft occlusion. Right common iliac artery occlusion limited conventional femoral arterial support. Subclavian venoarterial extracorporeal membrane oxygenation preserved left transfemoral access for transcatheter aortic valve replacement, which was followed by left radial rotational atherectomy–assisted left anterior descending percutaneous coronary intervention.  Discussion: This case illustrates individualized access planning and transcatheter aortic valve replacement-first sequencing to facilitate protected complex percutaneous coronary intervention and safe venoarterial extracorporeal membrane oxygenation weaning in cardiogenic shock.
SN  - 2666-0849
ER  -