IMPELLA-SUPPORTED HIGH-RISK PCI AS AN ALTERNATIVE TO CABG IN A PATIENT WITH SEVERE LV DYSFUNCTION AND MULTIVESSEL DISEASE.

A 78-year-old male with non-ST elevation myocardial infarction (NSTEMI) and severe left ventricular dysfunction (LVEF 25%) underwent Impella-supported high-risk percutaneous coronary intervention (PCI) for complex multivessel coronary artery disease. Coronary angiography performed via the right radial approach revealed significant disease in the left anterior descending artery (LAD), obtuse marginal branch (OM), and right coronary artery (RCA). Impella-assisted PCI to the left main and LAD using rotational atherectomy and a cutting balloon was successfully performed without complications.

This case highlights that Impella-supported high-risk PCI can serve as a viable alternative to coronary artery bypass grafting (CABG), demonstrating favorable short- and long-term outcomes, particularly in patients where individualized risk assessment and comorbidities complicate the choice of revascularization strategy