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Complex Case: LM and LAD

Chapter
Part of the Clinical Cases in Interventional Cardiology book series (CCIC)

Abstract

A 69-year-old female was admitted for unstable angina. She had cardiovascular risk factors of diabetes mellitus, hypertension, and hyperlipidemia. She also had end-stage renal failure secondary to diabetic nephropathy and was on hemodialysis. She presented with severe chest pain 1 month prior to presentation. A diagnostic angiogram done earlier showed severe critical left main disease (Fig. 10.1a, b; Video 10.1a, b). Physical examination was unremarkable. After discussion, she declined high-risk surgery and decided for high-risk PCI.

Supplementary material

Video 10.1

This shows the severe calcific stenoses of the LM and LAD (MPG 1374 kb)

Video 10.2

This shows the severe calcific stenoses of the LM and LAD (MPG 1305 kb)

Video 10.3

This shows rotational atherectomy being performed at 150,000 rpm. Note the gentle contact against the lesion, allowing for a “sandpapering” effect (MPG 1272 kb)

Video 10.4

This shows the sluggish slow or slow flow after rotational atherectomy (MPG 986 kb)

Video 10.5

This shows rotational atherectomy with a 2.0 mm burr (MPG 1275 kb)

Video 10.6

The flow in the LAD after rotablation is now TIMI 3 (MPG 538 kb)

Video 10.7

These movies show the excellent final angiographic results (MPG 949 kb)

Video 10.8

These movies show the excellent final angiographic results (MPG 1102 kb)

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.National Heart Centre SingaporeSingaporeSingapore

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