Case and Plan:
61 year old male. Presented with NSTEMI @OSH on Feb 7, 2022 with failed PCI of culprit RCA with 2 V CAD. No prior cardiac history until recent presentation. Pt was transferred for salvage culprit PCI of RCA which required ELCA+DES. Pt did well subsequently but still with CCS class II angina. Echo LVEF 45%. Cath on Feb 7th 2022 revealed 2 V CAD: 99-100% calcified segmental RCA, multiple calcified lesions in prox-mid LAD/D1 bifurcation and Syntax score 26. Pt underwent PCI of RCA requiring ELCA due to un-crossable lesion & 1 Promus Elite DES. Medications:
Aspirin, Lopressor XL, ISMN, Losartan, Ticagrelor, HCTZ, Atorvastatin. Now planned for physiology/imaging guided staged PCI of calcified LAD/Diagonal bifurcation using RA+DES.
