Case and Plan:
77 year-old male with stable class II angina and exertional dyspnea was noted to have calcified 90-95% left internal carotid artery stenosis on carotid duplex for ongoing neurological symptoms. A Cardiac Cath on November 18, 2019 as the part of pre-op evaluation for carotid endarterectomy revealed calcified severe 2V (RCA and LCx) and 90% distal left main disease with SYNTAX Score of 26, LVEF 60% and moderate AS (MG 15 mmHg, AVA 1.2 cm2). After Heart Team discussion, CABG was declined due to ongoing neurological issues & moderate AS and PCI was recommended. Patient is now planned for IVUS guided high risk PCI of calcified distal LM using rotational atherectomy and single crossover stent approach.
Left SFA CTO – Oct. 2019
68 year old female with HTN, DM, HLD who presents with life style limiting claudication, that has progressed to pain a rest. She had a non invasive workup done revealing abnormal ABI. She had a subsequent peripheral angiogram done revealing mid Left SFA total occlusion and referred for further intervention.
Recanalization of a complex RCA CTO using Antegrade/Retrograde Approach – Oct 2019
50-year-old female with multiple CAD risk factors presented with new onset CCS Class II angina for two months and stress echo revealed moderate inferior ischemia. A Cardiac Cath on October 7, 2019, performed at an outside hospital, revealed 1 V CAD: CTO of prox RCA, which fills via collaterals from left system with non obstructive […]
Impella Assisted Protected Multivessel PCI using Rotational Atherectomy – Sept 2019
62-year-old male presented with new onset Class III angina, NIDDM and positive MPI for multivessel ischemia in inferior, lateral and anterior walls. A Cardiac Cath on September 6, 2019 revealed 3V CAD: 100% proximal RCA, 80% calcified proximal LAD/D1 bifurcation Medina (1,1,1), calcified 80% mid LAD, calcified diffuse subtotal LCx-OM2 with SYNTAX Score of 39 […]
FFR & OCT Guided Staged PCI of LAD Diagonal Bifurcation – Aug 2019
Tags: Bifurcation | Complex coronary | LAD
50-year-old female with new onset Class II angina and strongly positive stress MPI for multivessel myocardial ischemia with TID. A Cardiac Cath on June 26, 2019 revealed 3V CAD: 70% severely calcific prox LAD with diagonal bifurcation, 80% LCx-LPL, 80% mid RCA with SYNTAX Score of 23 and LVEF of 60%. Patient underwent successful DES […]