Bifurcation PCI in Cardiogenic Shock and High-Risk PCI-Impella Supported LM DK Culotte in Cardiogenic Shock

Video Transcription

Video Summary

Dr. Alex Truesdale discusses a complex case of left main bifurcation intervention in a 60-year-old male patient experiencing cardiogenic shock, supported by a ventricular assist device. The patient presented with symptoms including tachycardia, hypotension, and elevated lactate levels. Initial tests showed no significant right coronary artery disease but revealed a complex trifurcation issue in the left main artery leading to almost complete blockage.<br /><br />Dr. Truesdale emphasizes the importance of comprehensive heart team evaluations over immediate surgical interventions, allowing consideration of various treatment pathways, including CABG, PCI, and medical therapy. He highlights meticulous procedural techniques, particularly in securing hemodynamic support before proceeding with PCI, using intracoronary imaging and Impella support to stabilize the patient's condition.<br /><br />Dr. Truesdale demonstrates the steps for DK Coulot stenting, advocating for a careful, step-by-step approach and the importance of continued post-operative care, including hemodynamic monitoring and patient recovery in the ICU.

Asset Subtitle

Alex Truesdell, MD, FSCAI

Keywords

bifurcation intervention

cardiogenic shock

ventricular assist device

hemodynamic support

DK Coulot stenting

intracoronary imaging