The second day of the event featured the Case presentation session “CIAT International Best Case”, which was moderated by Dr. Pavit Pienvichit, and Dr. Tanyarat Aramsareewong. The session had Drs. Shoichi Kuramitsu, Fuminobu Yoshimachi, Chaiyasith Wongvipaporn, Hiroaki Matsuda, and Muenpetch Muenkaw as Judges.

The first presenter, Dr. Chieko Itamoto of the Department of Cardiology, Nagano Chuo Hospital, Japan presented a “Case of Left Main Trunk Acute Myocardial Infarction Successfully Treated Using Impella Before PCI”. This was a case of a 74-year-old-man who had chest pain and syncope as major complaints. The patient had a history of Acute Myocardial Infarction, and smoked 30 cigarettes per day for 35 years. Physical examination showed a blood pressure of 125/77 mmHg and heart rate of 78 beats per minute, the operator suspected the Left Main Trunk to be the culprit lesion. The first approach was to insert Impella due to unstable vital sign.

Angiography showed that the right coronary artery was patent. PCI was performed with 7Fr JL3.5 guide catheter and crossed Sion blue wire in LAD. The LAD and LCx were subsequently dilated,  stent placement was made to the LAD. Good flow was observed in the LCx, hence the PCI was concluded. In this case, Impella, which was inserted before PCI, prevented severe deterioration of cardiac function.