High-risk percutaneous procedures are necessary in patients with contraindications to surgery in whom the inherent risk of the underlying disease is very high. Circulatory support may be provided with an intra-aortic balloon pump. If active cardiac support is required different devices have been successfully used.

We report the case of a 75-year-old patient admitted in cardiogenic shock with a severe coronary three-vessel disease with distal left main stenosis. The ejection fraction was 23%. The high-risk PCI of the distal left main coronary artery and left circumflex artery PCI as the main supplying vessel was supported by Lifebridge (Lifebridge Medizintechnik GmbH, Ampfing, Germany), a new portable mechanical circulatory support system. During the procedure we evaluated the macro- and microcirculation. The complex procedure succeeded with a flow of 2–2.5l providing both adequate macro- and microcirculation.