Complex PCI for Patient with Cardiomyopathy

March 29, 2018

Dr. Anmar Kanaan of Cleveland Clinic Akron General joins Dr. Cathy Jeon to discuss a case of a 60 year old male who presented with episodes of ventricular tachycardia and firing of his AICD. The patient has a history of tobacco abuse, severe COPD, complex coronary artery disease with a previous stent in his left circumflex as well as ischemic cardiomyopathy. Additionally, the patient had severe PVD and had a single kidney due to a nephrectomy as a child.

The team stabilized the patient and found multiple stenosis in the ischemic evaluation, including severe ostial left main with a 99% stenosis, minimal LAD disease, ostial RCA disease with 80% stenosis. The patient’s EF was 20%. The patient was referred for CABG, but was turned down due to his multiple co-morbidities and his frailty. The heart team met and an interventional approach was decided upon. Due to the severe LV systolic dysfunction and the severe stenosis of the left main coronary artery along with concomitant RCA disease, the need for hemodynamic support with Impella CP was recognized.

Tune in to hear how this challenging case resulted in a successful outcome.

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