Patient was transferred to (b)(6) hospital for cardiac catheterization.Cardiac catheterization shows lima(left internal mammary artery) to lad(left anterior descending artery) was patent and native right coronary artery had a subtotal in-stent restenosis in the proximal segment.Balloon angioplasty followed by rotational atherectomy was performed.Procedure complicated by rotafloppy wire breaking off at the tip and remaining in the distal right coronary artery/right pda(patent ductus arterisus).Multiple attempts were made with snare, double wire technique to retrieve the wire.This was complicated by the wires getting pinned in the native right coronary artery with occlusion of the right coronary artery leading to acute inferior myocardial infarction.Surgical consult was obtained for emergency salvage bypass surgery and retrieval of retained wire.Given unstable condition with acute inferior myocardial infarction, patient being on antiplatelet therapy and being a p2 sternotomy he was considered high risk.Surgical consult with vascular surgery was obtained to see if the retained wires could be retrieved through brachial cutdown approach which was attempted.Patient became hemodynamic requiring intubation, cpr pressor support.Despite multiple efforts we were unable to resuscitate the patient.Finally after discussion with the family resuscitation efforts were discontinued.Patient expired at 10:30 pm.
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