- Patient initials or identifier number:
-Relevant clinical history and physical exam:
We have a 53 years old male with background Diabetes Mellitus and Hypertension. He had underwent bypass surgery previously in 2013 with 3 saphenous venous grafts. He complained of chest pain for 4 days, in which he was referred to us from another centre for urgent graft study.
-Relevant test results prior to catheterization:
Baseline Echocardiography showed LVEF of 33%. Otherwise clinically he was unremarkable with clear lungs on auscultation.Coronary angiogram of native coronary arteries showed severe 3-vessel coronary artery disease with complete occlusions in all vessels. On top of that distal vessels of LAD and OM showed diffuse disease.
- Relevant catheterization findings:
Grafts were checked. One stump was found. Saphenous venous graft to LAD had severe disease in the proximal part. Saphenous venous graft has tight stenosis in the proximal part with long thrombus arising from plaque.In view of absence of support from native vessels, patient was counselled on high risk PCI.