JACC

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-067 . Presentation

Presenter

Steven Setiawan

Authors

Steven Setiawan1, Janry Anton Pangemanan1, Agnes Lucia Panda1, Pricilia Liliana Chendra1, Christian Sunur1, Agustinus Mahardhika Sarayar1

Affiliation

Sam Ratulangi University, Indonesia1,
View Study Report
TCTAP C-067
CORONARY - Complications

Multiple Coronary Aneurysm During Coronary Angiography

Steven Setiawan1, Janry Anton Pangemanan1, Agnes Lucia Panda1, Pricilia Liliana Chendra1, Christian Sunur1, Agustinus Mahardhika Sarayar1

Sam Ratulangi University, Indonesia1,

Clinical Information

Patient initials or Identifier Number

MT

Relevant Clinical History and Physical Exam

A 50-year-old woman came to the emergency department with dyspnea 6 days prior to admission. She was also complaining chest pain during physical activity which could be relieved by resting. She was a heavy smoker and had quit 2 years ago. No past medical history was reported. Hemodynamic was stable but there were dynamic ST-T changes on electrocardiography test during hospitalization.

Relevant Test Results Prior to Catheterization

NA

Relevant Catheterization Findings

LM: NormalLAD: Diffuse stenosis 90 - 95 % proximal-distal with multiple aneurysms, calcified (+)LCx: Diffuse stenosis 80 - 85 % proximal-distal with aneurism, diffuse stenosis 90 - 95 % at OM1RCA: CTO distal (collateral from LCx), tubular stenosis 80 - 90 % proximal and tubular stenosis 80 - 90 % mid with aneurysm
CA LAD.mp4
CA LCx.mp4
CA RCA.mp4

Interventional Management

Procedural Step

Radial access was chosen in this procedure and CLS 3.5/6 Fr as guiding catheter. Balancium guidewire was able to cross lesion in distal LAD. We predilate the lesion in proximal-mid LAD several times with Saphire 1.00 x 8 mm balloon to 20 atm, Mini Trek 1.20 x 12 mm balloon to 22 atm, NC trek 2.25 x 12 mm balloon to 20 atm and NC Trek 3.00 x 15 mm balloon to 16 atm. Combo plus 3.00 x 23 mm stent was deployed in proximal-mid LAD to 14 atm. Post dilatation with 3.00 x 23 mm balloon stent to 18 atm was done in proximal-mid LAD and coronary angiography evaluation showed TIMI 3 flow result with residual stenosis 30 - 40% in distal LAD.
Balancium guidewire.mp4
Deployed stent.mp4
Final result.mp4

Case Summary

Coronary artery aneurysm is an uncommon entity and is frequently found incidentally during coronary angiography. The majority of coronary aneurysms are atherosclerotic in origin. Treatments consisted of stent insertion during percutaneous coronary intervention. Dual antiplatelet therapy and statin were given after the procedure.

Leave Comments

Andreas Erick Haurissa Apr 19, 2021
Thank you for interesting case.
TCTAP 2021 Virtual Apr 12, 2021
Excellent management! Thank you for sharing it.