JMIR Publications

JMIR Cardio

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Currently submitted to: JMIR Cardio

Date Submitted: Sep 14, 2017
Open Peer Review Period: Sep 16, 2017 - Nov 11, 2017

NOTE: This is an unreviewed Preprint

Peer-Review Me

A Case Report of High-risk Multi-Vessel Percutaneous Coronary Intervention Using Impella CP with Severe Mitral Regurgitation

  • Devina Singh; 
  • Krunalkumar Patel; 
  • Rajkumar Doshi; 
  • Perwaiz Meraj

ABSTRACT

Unstructured:

Percutaneous Coronary Intervention (PCI) becomes a high-risk procedure when accompanied by several factors such as low ejection fraction, congestive heart failure, multi-vessel disease and severe mitral regurgitation. These factors cause a substantial increase in associated morbidity and mortality. Percutaneous Left Ventricular Assist Devices (pLVAD) assist in betterment of outcomes, in these patients. Here, we present a case documenting the utility of Impella CP, a pLVAD in high risk PCI. Our patient presented with myocardial infarction that was complicated by heart failure and mitral valve abnormality. Coronary angiography reported multi-vessel disease and was deemed unsuitable for surgery due to associated high-risk conditions. Thereafter, PCI was performed on this patient using Impella CP. The procedure was successful with no peri- and post-procedure complications even at 1-year follow-up. Impella CP is a micro-axial pump, which advances blood flow into the aorta from the left ventricle. It is advantageous for being minimally invasive and effective in decreasing end diastolic left ventricular volume. It should be attempted in unstable patients with severe coronary lesions and high-risk mortality with cardiac surgery.