Left Main PCI During Cardiac Arrest With Ongoing Lucas CPR.

Area of Science:

• Cardiology
• Interventional Cardiology
• Critical Care Medicine

Background:

• Percutaneous coronary intervention (PCI) in patients experiencing cardiac arrest poses significant challenges due to hemodynamic instability and compromised imaging quality.
• Optimal medical therapy for worsening angina can be insufficient, necessitating urgent revascularization.

Observation:

• A 75-year-old male patient undergoing PCI for left anterior descending artery stenosis experienced cardiac arrest post-balloon rupture, resulting in severe coronary no-reflow.
• Mechanical CPR using the LUCAS device was initiated, providing continuous chest compressions and supporting procedural imaging.

Findings:

• The use of mechanical CPR allowed for successful stenting of a critically narrowed, unprotected left main coronary artery despite the cardiac arrest.
• Uninterrupted mechanical compressions maintained hemodynamic stability and procedural visibility, crucial for complex interventions.

Implications:

• Mechanical CPR can be a valuable tool to facilitate complex PCI in patients suffering cardiac arrest within the cardiac catheterization laboratory.
• This case highlights mechanical CPR as a potential bridge to revascularization for select patients experiencing cardiac arrest during coronary interventions.