Case and Plan:
74-year-old female with multiple CAD risk factors and NIDDM and prior PCI, presented with exertional angina. A stress MPI revealed moderate anteroapical ischemia. A Cardiac Cath on Nov. 10, 2020 revealed 80% eccentric calcified distal left main disease, SYNTAX Score of 20 and LVEF=60%. IVUS revealed distal LM MLA of 4.5 mm2 with concentric severe calcification. Patient is planned for IVUS guided rota stent of distal left main.