Case and Plan:
85-year-old female with multiple medical problems (CVA, Asthma, SLE, CKD, DM, Afib) presented with CCS Class III angina and positive SPECT MPI with anterior apical and inferior ischemia. A Cardiac Cath on November 18, 2021 revealed 2 V CAD: multiple 80% lesions in RCA and heavily calcified 80-90% proximal LAD-D1 bifurcation with SYNTAX Score of 22 and normal LV function. Patient underwent successful intervention of multiple RCA branches using two Promus Elite DES. Patient is now planned for staged PCI of calcified LAD-D1 bifurcation using IVL + Rota with OCT imaging for calcium characterization.
