1st Operator: Byeong-Keuk Kim / 2nd Operator: Jung-Hee Lee

A 44-year-old man has CAD 1VD (dRCA) revealed by heart CT. We found hypokinetic myocardial wall motion on RCA territory by echocardiography and also positive findings of TMT.

• Previous MI: N

• Previous CABG : N

• Previous PCI: N

• Other: Lt MCA infarction (s/p Lt proximal ICA stent insertion)

• Diabetes: N
• Hypertension: Y
• Hyperlipidemia: Y

• Smoking: N
• Family History: N

• Age: 44
• Sex: Male

Stable angina

Echocardiography

Moderate to severe hypokinesia, LVEF 49%

Treadmill test

Positive at stage III (max 13.4 METs)

Thallium SPECT

Not done

CTO at dRCA with visible island just distal to the proximal stump
Collateral flow from septal a to dRCA
Collateral flow from dLAD to LCx
CTO at dLCx

Target Lesion(s)

dRCA

• ASA: Y
• LMWH: N

• Clopidogrel: N
• Heparin: N

• Nitrates: N
• IIb/IIIa: N

• Other: ticlopidine, carvediolol SR 16 mg, banidipine 5 mg, diltiazem SR 90 mg bid, atorvastatin 80 mg, trimetazidine 35 mg bid