Abstract
A sixty-year-old man with acute myocardial infarction and developing cardiogenic shock was admitted for emergency coronary angiography, revealing 30% left main stenosis, 90% left anterior descending artery (LAD) stenosis and 50% circumflex (LCX) stenosis. Successful dilatation of the LAD/LCX with drug-eluting stents (kissing stent technique) was accomplished via percutaneous coronary intervention, followed by Impella CP percutaneous assist device (Abiomed US, Danvers, Massachusetts, USA) insertion due to progressive hemodynamic instability.
Severe left ventricular (LV) dysfunction with an ejection fraction of 25% persisted over the next twelve days with failure to wean the patient from Impella CP, despite combined inotropic support, including levosimendan. Given the insufficient LV recovery, contrasted with only moderate right ventricular dysfunction, and the absence of concomitant valvulopathies, the patient was scheduled for a less invasive LV assist device implantation (HeartMate 3, Abbott, Abbott Park, IL, USA).
The patient was discharged twenty-one days post-implant.