COMBINED PTCA AND AORTIC VALVULOPLASTY FOR ACUTE MYOCARDIAL-INFARCTION COMPLICATED BY SEVERE AORTIC-STENOSIS AND CARDIOGENIC-SHOCK

Percutaneous aortic valvuloplasty (PAV) performed in patients with cri tical aortic stenosis has been shown to increase aortic valve area, de crease aortic valve gradient, and improve left ventricular function, H owever, the procedure is limited by rapid restenosis, Aortic valvulopl asty in the setting of critical aortic stenosis with cardiogenic shock can be a life-saving procedure, although morbidity and mortality rema in high. We describe a patient with critical aortic stenosis who prese nted with an acute anterior myocardial infarction treated with primary angioplasty, Despite rapidly achieving patency of the culprit vessel, the patient spiraled into cardiogenic shock, which prompted an emerge nt PAV. (C) 1997 Wiley-Liss, Inc.