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Updated: Aug 9, 2026
Utilizing Percutaneous Ventricular Assist Devices in Acute Myocardial Infarction Complicated by Cardiogenic Shock
Published on: June 12, 2021
Transradial unprotected left main coronary stenting supported by percutaneous Impella Recover LP 2.5 assist device
H H Minden1, H Lehmann, J Meyhöfer
1Immanuel Diakonie Group, Heart Center Brandenburg in Bernau, Department of Cardiology, Bernau, Germany. h.minden@immanuel.de
Insights
High-risk percutaneous coronary intervention (PCI) for complex left main stenosis in a patient with severe left ventricular dysfunction and leukemia was successfully performed using Impella hemodynamic support. This approach offers a viable alternative to surgery in complex cases.
Area of Science:
- Interventional Cardiology
- Cardiovascular Medicine
- Medical Devices
Background:
- Percutaneous coronary intervention (PCI) is increasingly used for complex coronary lesions and depressed left ventricular function.
- Hemodynamic support devices can mitigate complications in high-risk PCI procedures.
Observation:
- A 79-year-old male with unstable angina presented with multivessel disease and significant distal left main stenosis.
- The patient had chronic lymphatic leukemia with immune hemolysis, posing exceptionally high mortality risk for cardiac surgery.
Findings:
- Percutaneous revascularization of the left main stenosis was performed using the Impella Recover LP 2.5 assist device.
- Successful hemodynamic support during PCI in a complex, high-risk patient.
Implications:
- This case highlights the utility of the Impella device for high-risk PCI in patients unsuitable for surgery.
- Discusses indications, technique, and potential complications of Impella-supported PCI for left main disease.
Abstract:
Percutaneous coronary intervention (PCI) has been increasingly applied to patients with severely depressed left ventricular function and complex coronary lesions. The availability of hemodynamic support devices offers a promising option to reduce PCI-related complications in high-risk procedures. We report the case of a 79-year-old man who suffered from unstable angina. The coronary angiogram revealed multivessel disease including a significant distal left main (LM) stenosis. Additionally, the patient had a history of chronic lymphatic leukemia with immune hemolysis. Therefore, the patient was considered to be at exceptionally high mortality risk in case of cardiac surgery. We decided to perform a percutaneous revascularization of the LM supported by the Impella Recover LP 2.5 assist device. This case report discusses the principles of indications, technique and complications of this new addition to interventional cardiology.
