Complex Case: Severe Diffuse LAD Disease

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

Abstract

A 64-year-old gentleman was admitted for gangrene of the left lower extremity and developed recurrent non-ST elevation myocardial infarct with congestive cardiac failure. He had multiple cardiovascular risk factors of diabetes mellitus, hypertension and hyperlipidaemia. He also had a previous cerebrovascular infarct involving the right middle cerebral artery (MCA) and renal impairment. A diagnostic angiogram done earlier showed severe triple vessel disease with a previously known chronic total occlusion involving the right coronary artery (Figs. 20.1, 20.2, 20.3, and 20.4; Videos 20.1, 20.2, 20.3 and 20.4). A two-dimensional transthoracic echocardiogram showed that the left ventricular ejection fraction was impaired at 30%.

Supplementary material

Video 20.1

The baseline angiogram showed a heavily calcified diffusely diseased LAD (MP4 996 kb) (MPG 996 kb)

Video 20.2

The baseline angiogram showed a heavily calcified diffusely diseased LAD (MPG 934 kb)

Video 20.3

Baseline angiogram showing the diseased LCX (MP4 627 kb) (MPG 627 kb)

Video 20.4

Baseline angiogram showing the diseased LCX (MP4 1000 kb) (MPG 1000 kb)

Video 20.5

This shows rotablation of the LAD (MP4 324 kb) (MPG 324 kb)

Video 20.6

Angiogram of the LAD after rotablation (MP4 1503 kb) (MPG 1503 kb)

Video 20.7

Final angiograms showing the LM, LAD and LCX arteries (MP4 900 kb) (MPG 900 kb)

Video 20.8

Final angiograms showing the LM, LAD and LCX arteries (MPG 684 kb)

Video 20.9

Final angiograms showing the LM, LAD and LCX arteries (MP4 858 kb) (MPG 858 kb)

Video 20.10

Final angiograms showing the LM, LAD and LCX arteries (MP4 860 kb) (MPG 860 kb)

Video 20.11

(MP4 676 kb) (MPG 676 kb)

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  1. 1.Department of CardiologyNational Heart Centre SingaporeSingaporeSingapore
  2. 2.Department of CardiologyNational Heart Centre SingaporeSingaporeSingapore

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