Here is the link https://www.maxhealthcare.in/blogs/high-risk-cardiac-condition-managed-successfully
An 87-year-old patient visited Max Super Speciality Hospital, Bathinda, with a complaint of breathlessness. The patient had severe LV dysfunction EF20% and RWMA in multiple coronary territories along with borderline haemodynamics. The patient’s condition was critical, but her family was hopeful and consented to the treatment.
The doctors supported the patient on IABP and performed an angiogram after partial stabilisation, which revealed the Left main disease with TVD SCTVS. Then patient underwent protected PCI with Impella support.
Left main bifurcation was done under IABP support, but the patient still had borderline haemodynamics. She was discharged and re-admitted with breathlessness Class IV symptoms LBBB and borderline haemodynamics. This time the doctors decided to do CRTD, which was successful. The patient was active with no symptoms at all or at least less than class II, and the BP was 130/90
The case illustrates the successful use of IVL in LM Bifurcation. The patient was Hemodynamically unstable and had Class IV Symptoms; such patients require Protected PCI with Impella Support. Imaging with IVUS can be helpful for the characterisation of Calcium and its modification with IVL.