Hi everyone

Happy to share, one interesting complex case, which was done in our Cardiology department cath lab last week.

Patient 70 Yr old male Post CABG done 10 years back in Vizag, suffering from class 4 rest angina came to our evaluated thoroughly and planned for a Coronary angiogram..angiogram was done and showed all four grafts closed, and native vessels showing.

• LMCA OSTIUM 95 % stenosis
• LAD prox to mid 90 %stenosis
• LCX non-dominant mild disease
• RCA Chronic total occlusion CTO retrogradely filling from a lad
• Imp: LM OSTIUM PLUS DVD

We have planned to take this high risk for Stenting from LM OSTIUM TO LAD MID with TWO stents overlap.

Difficulties in this procedure were:

1. Total circulation of the heart is dependent on the LEFT Coronary artery (chance of hypotension and VT more during a procedure )
2. angle bw LAD AND LCX more than 90 degrees difficult to negotiate the Stent
3. Closure of Lcx artery during the procedure

With great difficulty and timely decisions, we completed this procedure successfully.
The patient was discharged yesterday from the hospital.