Hemodynamic support using the Impella 2.5 catheter system during high-risk percutaneous coronary intervention in a patient with severe aortic stenosis.

The Impella 2.5 catheter is a percutaneously implanted left ventricular assist device cleared by the Food and Drug Administration to provide circulatory support for up to 6 hours. The presence of aortic stenosis is deemed to be a contraindication to its use, and ongoing clinical trials exclude patients with an aortic valve area of 1.5 cm(2) or less. We describe a case of severe aortic stenosis with an estimated valve area of 0.9 cm(2) and severe ischemic cardiomyopathy in whom the Impella catheter was successfully used for high-risk multivessel percutaneous coronary intervention.