This case features a 62-year-old male with history of heart failure with reduced ejection fraction (HFrEF) 30-35%. The case features OCT and IVUS-guided Protected PCI and concludes with an on-table Impella® wean and dry closure. The procedural team at St. John Ascension Hospital in Detroit includes Amir Kaki, MD, Ted Schreiber, MD, Tom LaLonde, MD, Tamam Mohamud, MD, Chirdeep Patel, MD, with Seth Bilazarian, MD, from Abiomed. Chuck Simonton, MD, with panelists Lorenzo Azzalini, MD, Raj Patel, MD, and Samin Sharma, MD, participate in the discussion of the case.