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Lots of interesting abstracts and cases were submitted for TCTAP 2021 Virtual. Below are accepted ones after thoroughly reviewed by our official reviewers. Don’t miss the opportunity to explore your knowledge and interact with authors as well as virtual participants by sharing your opinion!

TCTAP C-058

Presenter

Manotosh Panja

Authors

Manotosh Panja1

Affiliation

Belle Vue Clinic, India1,
View Study Report
TCTAP C-058
CORONARY - Complications

Complication - Post PCI in a Case of LAD Calcified Lesion

Manotosh Panja1

Belle Vue Clinic, India1,

Clinical Information

Patient initials or Identifier Number

81Y/Male

Relevant Clinical History and Physical Exam

•       81Y/Male ex-smoker presented with chest pain (unstable angina) since 4-5 days•       Known case of hypertension, diabetes, hypercholesterolemia•       ECG- Anterolateral wall ischemia•       Echo shows EF 45%

Relevant Test Results Prior to Catheterization

•       ECG- Anterolateral wall ischemia•       Echo shows EF 45%

Relevant Catheterization Findings

•       Echo shows EF 45%•       CAG shows LAD long proximal calcified lesion, 85-90% with gross irregularity at the proximal part•       RCA distal lesion 85% with PDA 50-60%
cag1.avi
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Interventional Management

Procedural Step

RCA crossed with double wire technique. Lesion predilated and stented with 3x18 DES
and Post dilated with NC BalloonLAD-Lesion crossed with great difficulty with SION BLUE. Repeated NC balloon dilatation was done3.5X34MM DES was crossed with great difficulty and Proximaland distal Post dilatation done as well•       Patient was discharged- •       Asymptomatic and hemodynamically stable •       Brillinta Ecosprin and Statin hypertensive and Anti–Diabetic drugsAfter two weeks patient complained of chest pain. ECG no fresh changes, he was advised medical therapy After 1 week, patient was readmitted as he was refractory to medical therapy Check angio revealed huge aneurysm at proximal end of the LAD stentRCA showed patent stentImmediately the patient was referred to a cardiac surgeon for repair of aneurysm  followed by LIMAgraft in LAD
check angio2.avi

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Case Summary

•       Diabetes calcified with irregularity of proximal end of the LAD lesion subjected to PCI DES.•       Eventually, after two weeks, patient presented with chest pain.•       Check angio after 3rd week of PCI shows huge aneurysm at proximal end of the stentCause of the aneurysm may be due to trauma because of repeated post dilatation by NC balloonFinally, aneurysm repaired and LIMA graft. Patient was discharged

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