PMC9969903_01
PMC9969903_02
RCA showing diffuse disease (red arrow) with 80% mid-RCA occlusion.. RCA, right coronary artery
cureus-0015-00000034302-i01.jpg
PMC9969903_02_cureus-0015-00000034302-i01.jpg
FIG1
Left heart catheterization showed triple vessel coronary artery disease with 80% occlusion in the mid right coronary artery (RCA) with diffuse disease (Figure 1).
Bubble study showing significant right to left shunting across PFO, with complete opacification of the left ventricle at the P2 setting.. PFO, patent foramen ovale
cureus-0015-00000034302-i02.jpg
PMC9969903_02_cureus-0015-00000034302-i02.jpg
FIG2
The first injection at the P2 setting showed significant RTLS across PFO, with complete opacification of the left ventricle (Figure 2).
Bubble study showing a significant decrease in the right to left shunting across PFO at P6 setting/Impella RP support.. PFO, patent foramen ovale
cureus-0015-00000034302-i03.jpg
PMC9969903_02_cureus-0015-00000034302-i03.jpg
FIG3
The second injection repeated at the P6 setting also showed a RTLS, but the density of bubbles in the left side of the heart was significantly less compared to the first injection indicating a decrease of the shunt on Impella support (Figure 3).
PMC9969903_03
PMC9969903_04