Impella-Assisted PCI Of LAD And LCx Guided By OCT
Complex MultivesselCLINICAL SCENARIO: Presented to OSH w/ altered mental state and multi-organ failure. Elevated hs-Tn I
Dx: NSTEMI type I vs II
RISK FACTORS: HTN, DLP, active smoker
MEDICAL HISTORY: Hepatitis B, Hx of Amphetamine & Cocaine use, Alcohol abuse
CLINICAL EVOLUTION The patient was admitted with multi-organ failure (cardiogenic shock, acute renal + hepatic failure, delirium) due to acetaminophen intoxication. Due to a predominantly cardiogenic shock phenotype, TTE was performed: LVEF 20-25% with diffuse HK. Once stabilized, LV dysfunction prompted referral for diagnostic catheterization at his OSH Cath Lab.
Interventional Plan: Aim for complete revascularization. Adjust the plan according to IC Imaging (MLD-MAX OCT-based). Use of LV support: ULM-PCI. Use of LV support: Calcium modification. Start with RCA first (help for stability when going for ULM-PCI). Address LCx and LAD disease subsequently. Finish with ULM-PCI: Provisional > 2-stent strategy
Devices used in this procedure
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MitraClip for Severe Mitral and Tricuspid Valves Regurgitation In An Elderly Patient
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20:38
Multivessel PCI in STEMI Using RA
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Multivessel Disease Post Myocardial Infarction Using RA
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1:07:08
EVAR for Severe Abdominal Aortic Stenosis
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47:55
TAVI Using a 29 mm Evolut Valve
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