Live Relay: Mediquest – January 2023

Case & Plan:
65 yrs, M Presented with CCS Class II angina & DOE. Pt had +ctFFR of LM and prox LAD (0.72). No known prior CAD, echo revealed mild diffuse LV hypokinesis, LVEF 50%. Cardiac cath on January 17th 2023 revealed 2 V+LM CAD: calcified 60% distal LM bifurcation, 95% calcified prox LAD and 70% pLCx bifurcation, LVEF 50% and Syntax score 24. IVUS revealed MLA of LM 3.3mm2, LAD 4mm2 and LCx 2.5mm2 with +FFR. Now planned for imaging guided PCI of LM-LAD and LCx bifurcation lesion using Mini-Crush technique and possibly Rotational atherectomy (if moderate Ca++ on IVI).