It was reported that the patient died.The patient was treated for a chronic total occlusion (cto) of the right coronary artery (rca).The cto procedure was initially successful, but a non-boston scientific interventional wire dissected the artery from the proximal rca to the proximal posterior descending artery (pda), which was confirmed with intravascular ultrasound (ivus).A 2.50x16mm, 3.00x28mm, 3.50x38mm, and 4.00x16mm synergy xd drug-eluting stents were deployed from the proximal pda to the ostial rca, respectively.There was slow flow / no reflow, and the right ventricle (rv) marginal and posterior lateral branch were occluded.The patient presented with st segment elevation, which was attributed to branch loss, and the flow was restored to timi 2 / 1.Cangrelor was used to treat the event.While the patient was placed in holding for an available intensive care unit (icu) bed for overnight observation, the patient coded, re-stabilized and returned to the cardiac catheterization laboratory.The rca was re-accessed, and the physician proceeded to place a balloon pump in the patient for support.The rv marginal intervention was attempted, and accessed, but no progress was made, and the physician opted to bail on the intervention.The posterolateral branch of the rca was accessed, ballooned, and was not stented.During the procedure, the patient was in and out of arrhythmias, but no shock nor cardiopulmonary resuscitation was needed.A temporary pacer was placed in the rv and the patient was intubated.A residual hematoma was noted in the right groin femoral access.A non-boston scientific 5.5 ventricular assist device was placed, and the patient was sent to surgery to resolve the hematoma.The physician was expecting the patient to recover, however, on the next day, the patient passed due to cardiogenic shock.
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