Percutaneous Coronary Intervention in a Sitting Position During Heart Failure Following Myocardial Infarction

Percutaneous coronary intervention (PCI) typically requires supine positioning, which is not tolerated by individuals with severe heart failure (HF) after myocardial infarction (MI).

We report a 78-year-old man with post-MI HF and severe chronic obstructive pulmonary disease who could not tolerate supine positioning. After declining endotracheal intubation, he successfully underwent emergent PCI in a sitting position using a modified angiography setup, resulting in rapid symptomatic and functional improvement.

This case illustrates a novel and feasible approach for high-risk patients who cannot tolerate standard PCI positioning, enabling timely revascularization without general anesthesia and intubation.

To our knowledge, this is the first reported case of PCI in a sitting position in a post-MI HF patient.

Sitting-position PCI is a novel approach for revascularization and resulted in significant improvements in this patient.