Case and Plan:
60yrs, M with known CCD & PCIs Presented on 4/18/2025 with progressive dyspnea & CCS class III angina. HS-Tn normal. CTA with Ca+ score 1609 and EF 42%
Controlled Hypertension Uncontrolled NIDDM Controlled Lipids PAD s/p multiple PTAs & toe amputation SAQ-7 score: 74, Severely Obese LDL 56; CRP 2; SCr 1.0; HgA1C 9.6; BMI 37.9
Cardiac cath on 4/18/25 revealed 80% calcified LM bifurcation (1,1,1) and 3 V CAD, syntax score 31, LVEF 45% and STS risk score 2.4%. Heart team discussion considered pt as high surgical risk due to extensive PAD and amputations. Pt underwent RotaDES of RCA and did well. PRU 114 (responder).
Plan: Now planned for Imaging guided high risk staged PCI of LM bifurcation lesion using RotaTripsy and MiniCrush stenting. ?LV support
