The addition of femoral-femoral cardiopulmonary bypass in the cardiac catheterization laboratory to support the high risk patient is a challenging new frontier for percutaneous transluminal coronary angioplasty. We report our first experience of successful supported angioplasty in patient presented with exertional angina and orthopnea who had multi-vessel coronary artery disease with depressed left ventricular ejection fraction. Although cardiopulmonary support provides excellent support for high-risk patient, CPS is a technically challenging and expensive procedure associated with significant patient morbidity or complication. Despite its drawbacks, CPS has been shown to help save the lives of selected patients undergoing high-risk procedures.