MCS PROTECTED CHIP PCI in ACS – AMICS with recurrent In Hospital Cardiac Arrest
Presenter
Sivaramakrishnan Manoj, MBBS, MD, DNB, DM, DNB, FACC, FESC, FSCAI, KAUVERY HOSPITAL, CHENNAI, India
Sivaramakrishnan Manoj, MBBS, MD, DNB, DM, DNB, FACC, FESC, FSCAI, KAUVERY HOSPITAL, CHENNAI, India and Rajaram Anantharaman, MD, MRCP, KAUVERY HOSPITAL, CHENNAI, TAMIL NADU, India
Title
MCS PROTECTED CHIP PCI in ACS – AMICS with recurrent In Hospital Cardiac Arrest
Introduction
83years lady -T2DM, HTN, CAD – SVD of RCA x 10years on medical follow up, present admission with Pneumonia and ACS with Heart Failure
Clinical Case
This elderly lady developed refractory heart failure while being treated for Acute Pneumonia - COVID 19 EXCLUDED - and developed recurrent ischemic ST depression with LVEF ~25% and developed recurrent cardiac arrest in Coronary Care Unit, resuscitated and transferred to cath lab for diagnostic angiography and MCS support - IABP initially and upgraded to IMPELLA CP after effectively treating the Aorto-Iliac calcific occlusions using peripheral IV Lithotripsy while simultaneously addressing the Critical calcific Ostial LM stenosis with CHIP PCI.
Discussion
The need to anticipate access challenges in elderly subjects requiring large bore access and MCS initiation while also addressing the CHIP PCI to combined favorable cardiac outcome is discussed in AMICS and in-hospital cardiac arrest lady