Figure legends:
Fig. 1. Preoperative coronary angiography revealed (a) long segment multiple severe stenoses of left anterior descending, (b) severe stenosis in the proximal first marginal branch and downstream second stenosis of circumflex artery, and (c) segment 2 of the right coronary artery and posterior descending artery. (Black arrows show relevant stenosis)
Fig. 2. Postoperative chest radiography. (a). Initial support with venous-arterial extracorporeal membrane oxygenation (black line and arrows: venous cannula, white line and arrows: Impella; 7th postoperative day (POD)); (b) later downgrading of support to Impella (white line and arrows) combined with TandemHeart catheter (black dotted line and arrows; 11th POD).