Slides

LM with Trifurcation Lesion

- Operator : Seung-Jung Park

LM with Trifurcation Lesion
- Operators: Seung-Jung Park, MD, Ki Bae Seung, MD
Clinical Information

- Relevant clinical history and physical exam:
A 56-year-old woman was admitted with effort chest pain (crescendo type) for 1 month. One day ago, she suffered from resting chest pain. ECG showed non-specific finding, and biomarker was within normal range.

- Relevant test results prior to catheterization:
Echocardiography showed normal LV systolic function without regional wall motion abnormality.

- Relevant angiography findings:
Coronary angiogram showed a significant stenosis at left main coronary artery trifurcation site involving ostial left anterior descending artery. (Figure 1, Figure 2)
Interventional Management
- Procedural step:
A 8Fr sheath was inserted into the right femoral artery, and the left coronary ostium was engaged with a 8Fr JL guiding catheter with 4cm curve. A 0.014 inch BMW wires were inserted into the LAD, diagonal, and LCX respectively. IVUS was performed about LAD, diagonal, and LCX lesions. IVUS findings revealed heavy plaque burden in the LAD ostium (Figure 3) and LCX with near normal. Initially we predilated with 3.0 x 20mm Maverick balloon (Figure 4) and then Xience 4.0 x 28 mm stent were deployed. Final left angiogram showed that the procedure was successful (Figure 5, Figure 6).

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