Pt presented for elective percutaneous coronary intervention to left main coronary artery which was severely calcified and significantly stenosed.The revascularization plan included use of an impella device given pt's age and comorbidities.Pt was considered high risk for surgical revascularization and had declined surgery.After placement of impella device, pt became diaphoretic, pale, developed tachycardia and became unresponsive.Cpr initiated.Pt became hemodynamically unstable in hypovolemic/cardiogenic shock with pericardial effusion and tamponade from perforation of ventricle.Massive transfusion protocol initiated.Transported to operating room suite for repair of perforation.Post procedure, pt transferred to icu.Subsequently, developed hypotension and pea arrest.Resuscitation efforts unsuccessful.Pt expired.
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