Temporary Mechanical Circulatory Support in the Complex Vasculopath: Redefining What Is Possible

The use of temporary mechanical circulatory support in the management of a complex vasculopathy with severe cardiomyopathy.

A 64-year-old male presented with chest pain and dyspnea. He had severe bicuspid aortic stenosis, coronary disease, cardiomyopathy, and widespread vascular disease. He underwent aortic valve replacement with direct aortic Impella 5.5 followed by Impella-supported percutaneous coronary intervention, and carotid endarterectomy. Abdominal aortic aneurysm repair was performed prior to discharge.

Patients with severe cardiomyopathy should no longer be deemed prohibitive risk in the age of Impella 5.5. Multidisciplinary management is critical to ensure favorable outcomes.