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Imaging Guided PCI of Calcified LM Bifurcation and Additional Vessels with Impella Assistance

Case and Plan: 89-year-old male with known CAD, MI and remote PCI’s, now presented with CCS Class III angina and a positive SPECT MPI for multivessel ischemia and TID. A Cardiac Cath on July 9, 2024 revealed calcific 2V and LM CAD: 80% distal LM, 95% mid LAD, 90% annulated proximal LCx, 95% LCx-OM1 and OM2 ISR bifurcation with SYNTAX Score of 39 and EF 45%. After Heart Team discussion, high-risk protected PCI is recommended. Patient is now planned for imaging guided PCI of calcified LM bifurcation and additional vessels with Impella assistance.

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