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Lots of interesting abstracts and cases were submitted for TCTAP 2024. 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-097

The Story of Left Main

By Mohsin Ahmed, Shohely Binte Mostafa

Presenter

Shohely Binte Mostafa

Authors

Mohsin Ahmed1, Shohely Binte Mostafa2

Affiliation

National Institute of Cardiovascular Diseases, Bangladesh1, Rangpur Medical College and Hospital, Bangladesh2,
View Study Report
TCTAP C-097
Coronary - Complex PCI - Left main

The Story of Left Main

Mohsin Ahmed1, Shohely Binte Mostafa2

National Institute of Cardiovascular Diseases, Bangladesh1, Rangpur Medical College and Hospital, Bangladesh2,

Clinical Information

Patient initials or Identifier Number

Relevant Clinical History and Physical Exam

Patient Profile45-year-oldMaleHypertensiveDyslipidemia
Chief ComplaintsExertional chest discomfort, CCS Class III
S/P-PCI to RCA (2014)Re-look CAG done in 2018 showing Mild LM disease with mild LAD ostial diseaseOn Antiplatelet & anti-ischemic medications
Physical ExaminationsPulse: 80/min Blood Pressure: 130/70 mm-HgRespiratory Rate: 15/minSPO2   : >96% in room air


Relevant Test Results Prior to Catheterization

Relevant Catheterization Findings

Interventional Management

Procedural Step

LAD engaged with XB-3.5 (7F). Wiring of both LAD & LCX done.Pre-dilatation (2.5x15 mm NC Balloon) at 10-12 atm.After Pre Dilatation.Left Main-LAD: 3.5x23 mm  DES, 12-16 atm.Left Main-LAD: 3.5x23 mm  DES, 12-16 atmLeft Main-LAD: 3.5x23 mm  DES, 12-16 atmPost Dilatation (4x10 mm NC Balloon) At 12-18 ATM.POT.Final Cine.Post PCI FFR.Patient symptomatic on optimal medical therapy.Re-look  CAG shows Intermediate lesion.FFR in proximal LAD.FFR in proximal LCX.Physiology Guided PCI: Current Status.                












Case Summary

When invasively assessing intermediate coronary disease, there is more to it than meets the eye.
Visual interpretation of the coronary angiogram is insufficient
Determining FFR provides information regarding the contribution of epicardial coronary disease to myocardial ischemia
Both anatomic & physiologic assessment will guide to optimal management.