Case and Plan:
81-year-old male presented with new onset CCS Class I angina and abnormal CCTA revealing 3 V + LM disease and CA++ score 4233. A Cardiac Cath on July 12, 2026 revealed severely calcified FFR significant 3 V + LM CAD: 60% distal LM, 90% prox LAD, 80-90% LAD-D1 bifurcation, 80-90% mid and distal RCA, 70-80% proximal LCx with SYNTAX Score of 31.Patient underwent successful orbital atherectomy (OA) followed by 2 DES of RCA with excellent results. Patient is now planned for imaging guided staged PCI of distal LM and proximal LAD and proximal LCx bifurcation using OA + DES and Mini-Crush technique.
