Complex coronary cases
Imaging-Guided High-Risk of LM Trifurcation LAD and LCx (edited case) – February 2019

57 year old diabetic male presented with new onset CCS Class II angina and positive stress echo for multisegmental wall hypokinesis. A Cardiac Cath on February 12, 2019 revealed diffuse 3 V and LM trifurcation disease with SYNTAX Score of 52 and EF = 55%. The Heart Team recommended surgical revascularization but was declined by the patient and family. The patient underwent DES PCI of RCA with excellent results. The patient is now planned for imaging-guided high-risk intervention of left main trifurcation, LAD and LCx disease with Impella LV support and dedicated 2-stent technique.

Moderator: Sameer Mehta, MD

19:08

comments

Leave a Reply

Your email address will not be published. Required fields are marked *


By submitting this form, you are consenting to receive marketing emails from: Mount Sinai Hospital, One Gustave L. Levy Place, Box, New York, NY, 10029, https://ccclivecases.org. You can revoke your consent to receive emails at any time by using the SafeUnsubscribe® link, found at the bottom of every email. Emails are serviced by Constant Contact

suggestion
Suggestions
Complex PCI of Tortuous Calcified RCA using Rotational Atherectomy with Guide Extension Catheter – April 2021
Views 492

Case and Plan 43-year-old morbidly obese male with ESRD on HD presented with new onset Class IV angina and NSTEMI (pTnI 2:1U). A Cardiac Cath on February 26, 2021 revealed 2 V CAD: multiple calcified 80-99% lesions in extremely tortuous RCA, 90% mid LAD, LVEF = 55% and SYNTAX Score of 27. Patient underwent successful […]


IVUS Guided PCI of LAD-D1 Bifurcation using Rotational Atherectomy and 2-Stent Mini-crush Technique – March 2021
Views 537

Case & Plan: 47-year-old female with ESRD on HD, presented with CCS Class I angina and a markedly positive SPECT MPI for anterior and lateral wall ischemia. A Cardiac Cath on February 23, 2021 revealed severely calcified 1 V CAD: 90% proximal LAD and diagonal bifurcation (Medina 1,1,1), 80% mid LAD and SYNTAX Score of […]


Complex prox RCA CTO Recanalization via Retrograde Approach – February 2021
Views 518

56-year-old male presented with Class III unstable angina and positive stress MPI for significant inferior ischemia. A Cardiac Cath on November 20, 2020 at outside hospital revealed 2 V VAD: 85% mid LAD, 70% D1 and CTO proximal RCA with distal vessel fills retrogradely via septal collaterals (J-CTO Score 3), LVEF = 50% and Syntax […]


High-Risk Complex PCI of Diffuse Multivessel CAD – January 2021
Views 744

  Case and Plan: 45-year-old male with multiple CAD risk factors presented to OSH on November 6, 2020 with unstable angina and positive ETT. A Cardiac Cath on November 9, 2020 revealed extensive 3V CAD: 100% mid LAD, 90% D2, 70% proximal LCx, 100% LCx-OM1, 100% mid RCA with LVEF = 60% and SYNTAX Score […]