Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don’t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!
TCTAP C-078
LAD-Diagonal Re-Bifurcation Stenting Technique in Presence of ISR With DES & DEB
By Hariom Tyagi
Presenter
Hariom Tyagi
Authors
Hariom Tyagi1
Affiliation
Lokpriya Hospital, India1,
View Study Report
TCTAP C-078
CORONARY - Complex and Higher Risk Procedures for Indicated Patients (CHIP)
LAD-Diagonal Re-Bifurcation Stenting Technique in Presence of ISR With DES & DEB
Hariom Tyagi1
Lokpriya Hospital, India1,
Clinical Information
Patient initials or Identifier Number
AK3775
Relevant Clinical History and Physical Exam
A 53 year old male patient presented with chest pain at rest for last 6 hours with DOE II &AOE II for last 6 months. Diagnosis HTN/ CAD/ACS/USA/ s/p PTCA to LAD,D1& RCA (2009/2010). ECG- Q wave in I aVL leads & poor R- wave Progression precordial leads, 2D Echo s/o Adequate LV systolicfunction ( LVEF 50%).
Relevant Test Results Prior to Catheterization
E.C.G.: NSR with LVH, DIAGNOSIS: HTN/CAD/ACS/USA/POST PTCA TO LAD, D1 & RCA(2009/2010)/ POST CAG-DVD WITH ISR (23.04.2018)/POST PTCA TO LCX(23.04.2018)/POST PTCA TO LAD & D1 (22.05.2018)/ADEQUATE LV SYSTOLICFUNCTION/LVEF=50%/ MODERATE MR/MILD AR.
Relevant Catheterization Findings
His angiogramrevealed – Mid LAD stent in Situ with 70% ISR. Large D1 with ostioproximal 90% disease. Co dominant LCX Mid 90 %disease. & RCA minimal ISR
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MOVIE-210001.wmv MOVIE-210002.wmv MOVIE-210003.wmvInterventional Management
Procedural Step
RightCoronary Artery was engaged with JR 3.5, 6F guide catheter. A 0.014” SION BLUE wirewas used to cross the RCA lesion. Pre dilation done with SC Sapphire Balloon 2.5x 10 mm @ 16 atmosphere. Drug Eluting Stent RESOLUTE INTEGRITY 3.5 x 34 mmdeployed in mid RCA @ 14 atmosphere and another Drug Eluting Stent RESOLUTEINTEGRITY 3.5 x 22 mm deployed in proximal RCA @ 14 atmosphere. Post dilationdone with NC Sapphire Balloon 3.5 x 10 mm @ 18 atmosphere. GP IIb IIIainhibitor was used during the procedure. Excellent result with TIMI III flow. SuccessfulPTCA with stenting to RCA.
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MOVIE-210047.wmv MOVIE-210048.wmv MOVIE-210049.wmvCase Summary
Percutaneous intervention with stent implantation for LMCA disease has become a standard procedure in contemporary practice with safety, expedited recovery, and durability. Precise selection of the strategy aided by intracoronary imaging, functional evaluation, and mechanical support when needed have improved the immediate and long-term results in this high risk intervention. It is however important to have a team approach and operator expertise before embarking on LMCA interventions.