Controlled Trial of High-risk Coronary Intervention With Percutaneous Left Ventricular Unloading

Inclusion Criteria

• •1. Extensive coronary disease defined by a British Cardiovascular Intervention Society (BCIS) Jeopardy Score ≥ 8\*
• •2. Severe left ventricular systolic dysfunction defined as a LVEF ≤ 35% (or ≤ 45% in the presence of severe mitral regurgitation)#
• •3. Complex PCI defined by the presence of at least one of the following criteria:
• •* Unprotected left main intervention in the presence of
• •* an occluded dominant right coronary artery, or
• •* a left dominant circulation, or
• •* disease involving the entire bifurcation (Medina 1,1,1 or 0,1,1)
• •* Intended calcium modification (by rotational or orbital atherectomy, lithotripsy or laser)
• •* in multiple vessels or
• •* in the left main stem, or
• •* in a final patent conduit, or
• •* where the anatomic SYNTAX score is ≥32
• •* Target vessel is a chronic total occlusion with planned retrograde approach
• •* Biplane / 3D echocardiography, or cardiac MRI can be used to assess the qualifying LVEF.