Against the Odds: Impella-supported revival in an octogenarian with cardiogenic shock (stage E) and advanced coronary artery disease

Abstract

This case report describes the extraordinary recovery of an 85-year-old male who presented with cardiogenic shock and severe calcified triple vessel- coronary artery disease. Despite severely reduced left ventricular function (EF 15%) and end organ dysfunction, he underwent successful high-risk PCI with Impella CP support, through a multidisciplinary approach combining mechanical circulatory support, precision interventional therapy, advanced renal support, and high acuity critical care nursing. The patient’s cardiac function was restored to EF 35% & he achieved full hemodynamic stabilization. This case underscores the vital role dedicated nursing care, nutritional support and precision cardiac care play to recover a heart that completely failed.

Patient was brought to our ER with no hope of survival since he had severe left ventricular failure with very low EF and renal shut down. In addition, he had sepsis. Despite all the adverse clinical co-morbid situations, with dedicated clinical multidisciplinary care and nursing support, our team helped saving the life of this elderly gentleman. Use of percutaneous cardiac pump like Impella CP in bridging recovery is complex in cardiac emergencies and exemplifies excellence in critical care nursing.

This case was one of the most challenging yet rewarding experiences in my career. With the support of the Impella device, we were able to maintain hemodynamic stability and gradually guide the patient towards recovery. Over 29 days, I was deeply involved in his daily care-monitoring, intervening, and advocating at every step. His survival was not only a clinical success but a testimony to our teamwork, technology, and relentless critical care. This case touched me profoundly and motivated me to document it as a journal entry, to share both knowledge, and honour the journey we took together.