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%.
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The baseline angiogram showed a heavily calcified diffusely diseased LAD (MP4 996 kb) (MPG 996 kb)
The baseline angiogram showed a heavily calcified diffusely diseased LAD (MPG 934 kb)
Baseline angiogram showing the diseased LCX (MP4 627 kb) (MPG 627 kb)
Baseline angiogram showing the diseased LCX (MP4 1000 kb) (MPG 1000 kb)
This shows rotablation of the LAD (MP4 324 kb) (MPG 324 kb)
Angiogram of the LAD after rotablation (MP4 1503 kb) (MPG 1503 kb)
Final angiograms showing the LM, LAD and LCX arteries (MP4 900 kb) (MPG 900 kb)
Final angiograms showing the LM, LAD and LCX arteries (MPG 684 kb)
Final angiograms showing the LM, LAD and LCX arteries (MP4 858 kb) (MPG 858 kb)
Final angiograms showing the LM, LAD and LCX arteries (MP4 860 kb) (MPG 860 kb)
(MP4 676 kb) (MPG 676 kb)
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Fam, J.M., Yeo, K.K. (2018). Complex Case: Severe Diffuse LAD Disease. In: Low, R., Yeo, K. (eds) Clinical Cases in Coronary Rotational Atherectomy. Clinical Cases in Interventional Cardiology. Springer, Cham. https://doi.org/10.1007/978-3-319-60490-9_20
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DOI: https://doi.org/10.1007/978-3-319-60490-9_20
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