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TCTAP C-050 Calcified Left Main Bifurcation Stenosis and Severe Triple Vessels Disease
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
S137
Final IVUS image showed all stents well expanded with good appositions, TIMI 3 flow on final angiography Patient made a good recovery and was able to be discharged one week after PCI.
Case Summary. This is a rare case of LCC aneurysm and dissection causing subtotal occlusion of LM, leading to anterior MI. In this case urgent Bentall and CABG procedure were considered as the best therapeutic option. Unfortunate acute graft closures leading to cardiogenic shock closures might be caused / related to its connection to ascending Ao prosthetics, background psoriasis, or methotrexate rebound effect. Fortunately emergency PCI to true LM bifurcation (with mini crush technique) was performed successfully as the final therapeutic solution for this patient.
TCTAP C-050 Calcified Left Main Bifurcation Stenosis and Severe Triple Vessels Disease Linda Lison,1 Teguh Santoso1 1 Medistra Hospital, Indonesia [CLINICAL INFORMATION] Patient initials or identifier number. BR Relevant clinical history and physical exam. 51 years old male, history of NSTEMI Risk factor: Dyslipidemia, Hypertension Electrocardiography: Sinus, QS in inferior Echocardiography: Hypokinetic inferior, posterior and lateral wall motion, left ventricule ejection fraction: 50% He was treated by Clopidogrel, Aspirin, Cilostazol, Diltazem, Valsartan Rosuvastatin, Pantoprazol.
S138
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
Case Summary. Multiple complex bifucartio left main and severe triple vessels disease in high risk patient, CABG (surgery) is a better choice than Percutaneous coronary intervention (PCI), however if can be the patient prefer to PCI, D-K-Crush techbique will achieved excellent result.
TCTAP C-051 A ST-Elevation Myocardial Infarction (STEMI) Patient with Left Main Coronary Artery Lesion - The Revascularization Was Successful or Not? [INTERVENTIONAL MANAGEMENT] Procedural step. Pasien refused to do any surgery, as he had syntax score >45. PCI was done via right artery femoral by using EBU 7 F guiding Catheter pre-dilatation LAD mid-segment, LAD proximal to Left main, and also LCX Mid segment -LCX proximal to left main, and implanted the stent to LCX mid segment, LAD mid segment, and then LM-LAD and LM-LCX implanted the 2 stents using Double kissing-Crush technique and overlapping with the stent in mid segment of LAD and LCX. And finally Proximal optimal Technique in Left main and final with POT (Proximal Optimalization technique). For RCA pre-dilatation in segment proximal mid segment and distal and then implanted the stent. For RPD pre-dilatation and then drug eluting balloon. Final Result was excellent.
Junhua Ge,1 Jian Li1 1 The Affiliated Hospital of Qingdao University, China [CLINICAL INFORMATION] Patient initials or identifier number. HZ W Relevant clinical history and physical exam. A 52-year-old male was admitted to our hospitalwith 1 hoursof severechest pain. He had suffered from intermittent chest discomfort for several months. The coronary risk factors includes: 5 year history of hypertension, dyslipidemia, smoking (200 pack-years) and drinking. Physical examinationincluded a temperature of 36.8 C, heart rate of 78beats/min, blood pressure 112/72 mmHg, respiratory rate 21 breaths/min. Basline Electrocardiogram (ECG) showed ST-segmentelevation in leads in leads I, avL, V1-V6. Systemic examination was unremarkable.
S137
Final IVUS image showed all stents well expanded with good appositions, TIMI 3 flow on final angiography Patient made a good recovery and was able to be discharged one week after PCI.
Case Summary. This is a rare case of LCC aneurysm and dissection causing subtotal occlusion of LM, leading to anterior MI. In this case urgent Bentall and CABG procedure were considered as the best therapeutic option. Unfortunate acute graft closures leading to cardiogenic shock closures might be caused / related to its connection to ascending Ao prosthetics, background psoriasis, or methotrexate rebound effect. Fortunately emergency PCI to true LM bifurcation (with mini crush technique) was performed successfully as the final therapeutic solution for this patient.
TCTAP C-050 Calcified Left Main Bifurcation Stenosis and Severe Triple Vessels Disease Linda Lison,1 Teguh Santoso1 1 Medistra Hospital, Indonesia [CLINICAL INFORMATION] Patient initials or identifier number. BR Relevant clinical history and physical exam. 51 years old male, history of NSTEMI Risk factor: Dyslipidemia, Hypertension Electrocardiography: Sinus, QS in inferior Echocardiography: Hypokinetic inferior, posterior and lateral wall motion, left ventricule ejection fraction: 50% He was treated by Clopidogrel, Aspirin, Cilostazol, Diltazem, Valsartan Rosuvastatin, Pantoprazol.
S138
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, VOL. 67, NO. 16, SUPPL S, 2016
Case Summary. Multiple complex bifucartio left main and severe triple vessels disease in high risk patient, CABG (surgery) is a better choice than Percutaneous coronary intervention (PCI), however if can be the patient prefer to PCI, D-K-Crush techbique will achieved excellent result.
TCTAP C-051 A ST-Elevation Myocardial Infarction (STEMI) Patient with Left Main Coronary Artery Lesion - The Revascularization Was Successful or Not? [INTERVENTIONAL MANAGEMENT] Procedural step. Pasien refused to do any surgery, as he had syntax score >45. PCI was done via right artery femoral by using EBU 7 F guiding Catheter pre-dilatation LAD mid-segment, LAD proximal to Left main, and also LCX Mid segment -LCX proximal to left main, and implanted the stent to LCX mid segment, LAD mid segment, and then LM-LAD and LM-LCX implanted the 2 stents using Double kissing-Crush technique and overlapping with the stent in mid segment of LAD and LCX. And finally Proximal optimal Technique in Left main and final with POT (Proximal Optimalization technique). For RCA pre-dilatation in segment proximal mid segment and distal and then implanted the stent. For RPD pre-dilatation and then drug eluting balloon. Final Result was excellent.
Junhua Ge,1 Jian Li1 1 The Affiliated Hospital of Qingdao University, China [CLINICAL INFORMATION] Patient initials or identifier number. HZ W Relevant clinical history and physical exam. A 52-year-old male was admitted to our hospitalwith 1 hoursof severechest pain. He had suffered from intermittent chest discomfort for several months. The coronary risk factors includes: 5 year history of hypertension, dyslipidemia, smoking (200 pack-years) and drinking. Physical examinationincluded a temperature of 36.8 C, heart rate of 78beats/min, blood pressure 112/72 mmHg, respiratory rate 21 breaths/min. Basline Electrocardiogram (ECG) showed ST-segmentelevation in leads in leads I, avL, V1-V6. Systemic examination was unremarkable.