Using Impella in a Left Main Tight Stenosis

An 84-year-old male presented with resting chest pain. He is status post abdominal aortic aneurysm repair and has hypertension and severe COPD requiring continuous oxygen therapy.  An outside angiogram revealed normal LV function and a normal right coronary angiogram with an ostial subtotal left main calcific stenosis. This case exemplifies the safety of using the Impella device in a high risk calcific ostial left main stenosis.  Because we could safely ablate the plaque and widely dilate the stenosis, we were able to optimize the results in this elderly patient. The Flash balloon further optimized the diameter of the left main stent. (See related blog post.)