CCC Live Cases > Peripheral > Subclavian Artery Stenosis Causing Refractory Heart Failure in a Patient Post CABG – December 2022

Subclavian Artery Stenosis Causing Refractory Heart Failure in a Patient Post CABG – December 2022

CASE & Plan:
HPI:

74 year old M with a PMH of HTN, HLD, CAD s/p CABG with LIMA to LAD.
Over the past 2 years he has developed progressive SOB and worsening ischemic cardiomyopathy.
On GDMT with aggressive cardiomyopathy treatment.
HFrEF continued to progress, EF now severely reduced, and patient is requiring home Milrinone.

Approach:

R CFA access with 7 Fr sheath.
Anterograde cross, if unsuccessful will consider radial or brachial access.
Calcium modification with IVL vs debunking strategy.
Stenting strategy

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