Case 40: PCI Manual - When everything goes wrong

[@aq4019]

One of the worst nightmares that could ever happen to surgeons, hats off to all ur team,sir!

[@MinorityDoc]

Very difficult to bail the patient out in such a situation. Imagine, leaving a closed RCA to manage the access complication. While the patient arrests. Hats off.

[@neeru.indian]

Great save.needs lot of guts and persistent efforts.

[@DrMusrafaduran]

It seems to me the patient discharged with very poor ejection fraction

[@moazAlhamedy]

Such an operative conundrum! Good job.

[@micger]

Wow what an amazing case! Thank you for sharing!

[@progreviews]

How do you differentiate whether you are in the false or true Lumen?

[@manosbrilakis]

The following suggest true lumen wire position: 1. Workhorse wire moving easily without knuckling and entering side branches 2. IVUS 3. Transducing pressure through a microcatheter (advance microcatheter over wire, then remove wire)

[@wanjae]

This was never an easy case at anytime. I wonder sometimes we should think of using tpa especially radial access. Stabilize and then attempt in a controlled setting. Just a thought. Although great save.

[@dobryi_chel]

Unbelievable case! How much time passed from cardiac arrest to ECMO connection?

[@manosbrilakis]

Approximately 15 minutes.

[@dobryi_chel]

At what level was the blood pressure during a non-direct massage of the heart?

[@rogeriomoura6557]

BEST ANGIOGRAPHIC RESULT BUT WHAT THE IMPROVEMENTS FOR PATIENT??IS THE DOUBT….NOTHING