- Patient initials or identifier number:
-Relevant clinical history and physical exam:
75 year olds lady with a background history of tissue aortic valve replacement and single Saphenous vein grafting to Obtuse Marginal branch in 2018, hypertension, Type 2 Diabetes Mellitus, and Transient ischaemic attack, presented to North Wales Cardiac Centre with non ST elevation myocardial infarction. Prior to her presentation she was complaining of increasing angina pain on exertion. Clinical examination did not show any evidence of heart failure. Coronary angio prior to surgery is below:
-Relevant test results prior to catheterization:
An echocardiogram showed well functioning AVR and normal LV systolic function.
- Relevant catheterization findings:
RRA 6F, JR 4 5F, EBU 3.5 6F Guide, JL 3.5 6F Guide (via RFA)RCA: Mild diseaseLMS: Severe narrowing at ostium extending to proximal segment. Noted TIMI 2 flow with severe haemodynamic compromise. Patient had PEA arrested on the table. Resuscitation and intubation was performed. LMS wired with SBW. stented with 4.0 x 15 mm Onyx. postdilated with 4.5 mm NCB. Mid LCx stented with 3.0 x 18 mm Onyx DES. Distal OM stented with 2.25 x 18 and 2.25 x 12 mm Onyx DES in overlapping fashion.