JACC

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TCTAP C-031

Presenter

Satish R Chirde

Authors

Satish Chirde1

Affiliation

Shri Datta Hospital And Research Center, India1,
View Study Report
TCTAP C-031
CORONARY - Bifurcation/Left Main Diseases and Intervention

LM Bifurcation PTCA by TAP

Satish Chirde1

Shri Datta Hospital And Research Center, India1,

Clinical Information

Patient initials or Identifier Number

201

Relevant Clinical History and Physical Exam

• 50/M non HTN,non DM underwent PTCA+ stent to LAD (3.5 x 18 SES) in June 2013• LAD ISR in nov2013• PTCA + DES toLAD (4 x23 pronova XR) in nov 2013• Now presentedwith effort angina 3 months
Ostial Lcx Lesion.mpg
Ostial Lcx Lesion.mpg

Relevant Test Results Prior to Catheterization

His ECG was normal.His CBC was normalS. Creat-- 0.9RBS> 130 mg%LFT -Normal2DECHO was normal

Relevant Catheterization Findings

CAG was done through Rt RadialLM to LAD stent was patentLCX--> Dominant, ostial 90% stenosisRCA-> Non Dominant normal
Ostial Lcx Lesion.mpg

Interventional Management

Procedural Step

Access: Right femoral arteryGuide; 7F EBUWires: 2 Rinato wires were usedLM was engaged with 7F EBU.LAD was crossed with Rinato0.014" LCx was engaged with 0.014 RinatoLCx lesion initailly predialted with 1.5 x8semicompliant sprinter balloonThen predialted with 2 x 8 semi-compliant up to 10 atmThen 3 x16 Resolute Onyx was implanted at Ostail LCx at 16 atmNo dissection, no slow flowFKI was done with 3x8 NC balloon in LAD and 3.5 x 8 NC balloon in LCx at 12 atmNo Slow flowFinal result was excellent
Stent implantation.mpg
FKI.mpg
final2.mpg

Case Summary

LM Interventions are very risky.Correct Technique are useful.This patient developed Ostial LCx Lesion which was successfully treated with PCI. DK crush could have been used but I preferred TAP.Result was excellent.Patient is asymptomatic in routine follow-up.