76-year-old female presented with new onset of CCS Class III angina and positive SPECT MPI for mild lateral ischemia. A cardiac cath two weeks prior to the procedure revealed three-vessel coronary artery and LM disease: 70% distal LM, 80% proximal LAD/D1 bifurcation, 80% long calcified aneurysmal mid LAD, 80% LCx-OM1. Patient had a SYNTAX score of 35 and LVEF of 60%. In view of high SYNTAX score, patient was referred for Heart Team discussion with recommendation for CABG, which was declined, and patient opted for multi-vessel PCI. The case describes complex intervention of LM and long calcified aneurysmal LAD lesions using OCT imaging for pre-procedural lesion characterization and stent assessment after PCI.
From CCC Live Cases