【Technological Breakthrough】Fu Wai Hospital Successfully Treats CHIP Patient: Precision PCI with IABP Support Opens the Aorta

Severe coronary artery stenosis, acute heart failure, advanced age, and a history of Coronary Artery Bypass Grafting (CABG)—when these high-risk factors converge, patient treatment often becomes a desperate situation. Recently, Dr. Zheng Xiaohui, Director of the Cardiac Emergency Department at Fu Wai Hospital, and his team, leveraging sophisticated skills and a willingness to tackle challenges, successfully performed Percutaneous Coronary Intervention (PCI) on a patient with a typical "CHIP" lesion. Crucially, the procedure was conducted under the life support of an Intra-Aortic Balloon Pump (IABP), precisely reopening the "life channel" and reviving a failing heart.

"CHIP" (Complex, High-risk, Indicated PCI) refers to patients with complex lesions and extremely high surgical risk who have an indication for revascularization but cannot tolerate open-heart surgery. These cases are considered the most difficult challenges in interventional cardiology. The patient in this case, Mr. Li (73), had undergone CABG in 2016. He was recently admitted due to recurrent and worsening symptoms of chest tightness and shortness of breath (signs of heart failure). Diagnostics revealed that the previously implanted saphenous vein graft was completely occluded. The remaining arterial graft was barely patent, and the crucial native Left Anterior Descending (LAD) artery—the main blood supply for the septal and diagonal branches—had critical stenosis. Interruption of blood flow in this vessel would be immediately life-threatening.

After multidisciplinary consultation, PCI was deemed the optimal solution. Dr. Zheng Xiaohui's team opted for IABP for circulatory support to maintain hemodynamic stability during the procedure. They employed innovative drug-coated balloon (DCB) angioplasty to precisely treat the stenosis, thereby avoiding the additional risks associated with traditional stent implantation. The team executed the procedure with millimeter-level precision, successfully dilating the stenotic vessel. Angiography immediately showed a significant improvement in blood flow, leading to instant myocardial reperfusion.

As a National Cardiovascular Regional Medical Center, Fu Wai Hospital has developed a mature "High-Risk Rescue System" for CHIP lesions. This system relies on advanced Mechanical Circulatory Support (MCS) technologies like IABP and ECMO, combined with a multidisciplinary collaborative model, to provide individualized interventional solutions for critically ill patients. This successful case not only demonstrates the hospital's elite capability in treating complex and high-risk cardiovascular diseases but also offers renewed hope to many similar patients worldwide.