By Dr. Arnav Kumar MD MSCR
Interventional Cardiologist
HCA Medical Center, Houston, Texas
Pt was 61 active pt – was sent from another hospital
Late presentation STEMI
The impella they had placed clotted his right leg.
Then he had 23 min code for VFiB arrest – I placed LFA/LFV ECMO bedside. He had right leg ischemia from the prior placed impella.
So I and vascular surgery switched to 5.5 impella via left subclavian.
So only two options for pci access were either radial or stick the ECMO circuit.
Angiogram with 100% LAD and LCX, 99% calcific LM.
We preformed ivus guided bifurcation PCI of LM-LAD-LCX after rotational atherectomy of the LM – LAD.
Also reconstructed the whole LAD.
Was able to do all radial fortunately.
GlobeMedic 