Case Review, Protected PCI
Severe Left Ventricular Dysfunction and Protected PCI
"If you're going to make a case for Protected PCI, this is the case for Protected PCI," Tom Mulhearn IV, MD, FACC, of Cardiovascular Specialists of Louisiana emphasizes as he presents a complex PCI case in the setting of severe LV dysfunction.
The 49-year-old male patient presented to a satellite office with chest pain. He had poorly controlled type II diabetes, hypertension, hyperlipidemia, and he was a smoker. An angiogram showed a normal left main, but significant LAD disease, a proximal lesion, an occluded vessel in the mid-segment, along with a circumflex that was non-dominant with high grade disease and an occlusion in the mid-segment. The team found a chronic total occlusion of the LAD and a near 100% occlusion in the mid-segment of the right coronary artery.
At the satellite office, Dr. Mulhearn placed a balloon pump because there were no other options at that location. The patient was transferred, referred for CABG, and was turned down due to profound LV dysfunction and comorbidities. The team therefore proceeded with a Protected PCI procedure with the Impella 2.5® heart pump using the left common femoral artery.
Watch the video to learn how the team revascularized this complex patient and how the patient’s hemodynamics remained stable throughout the case.
Additionally, learn more about Dr. Mulhearn’s decision-making process using hemodynamic support.