Slides TCTAP
[April 25] CTO LIVE_Severance Hospital, Seoul, Korea: Case #5
- Operator : Yangsoo Jang
1st Operator: Yangsoo Jang / 2nd Operator: Sung-Jin Hong
Brief Case Summary
A 74 year-old male patient, who had a history of old MI (1991) on medication and HTN, have suffered chest pain on exertion since 6 months ago. Previous coronary angiography showed total occlusion of m-LAD.
Past Medical History
- Previous MI: Y (1991)
- Previous CABG : N
- Previous PCI: N
Demographic Characteristics
- Diabetes: N
- Hypertension: Y
- Hyperlipidemia: N
- Smoking: N
- Family History: N
- Age: 74
- Sex: Male
Clinical Presentation
Stable angina (CCS class II)
Non-invasive Studies
Echocardiography
No RWMA, EF 68%, mild TR
Treadmill test
Not done
Thallium SPECT
Not done
Cardiac Catheterization Findings
Coronary angiography (2017.3.23)
- RCA
- Collateral flow GII/III from PD, PL to septal branch
- LCA
-
Total occlusion of m-LAD
tubular eccentric 70% LN of 1st Dg
collateral flow from Dg to dLAD
Case Notes
Target Lesion(s)
mid-LAD
Adjunctive Medication
- ASA: Y
- LMWH: N
- Clopidogrel: Y
- Heparin: N
- Nitrates: N
- IIb/IIIa: N
- Other: pitavastatin 4mg, amlodipine 5mg, carvedilolol SR 8mg, valsartan 80 mg
Coronary angiography (2017.3.23)
- Previous MI: Y (1991)
- Previous CABG : N
- Previous PCI: N
- Diabetes: N
- Hypertension: Y
- Hyperlipidemia: N
- Smoking: N
- Family History: N
- Age: 74
- Sex: Male
Echocardiography
No RWMA, EF 68%, mild TRTreadmill test
Not doneThallium SPECT
Not done- RCA
- Collateral flow GII/III from PD, PL to septal branch
- LCA
-
Total occlusion of m-LAD
tubular eccentric 70% LN of 1st Dg
collateral flow from Dg to dLAD
Target Lesion(s)
mid-LAD- ASA: Y
- LMWH: N
- Clopidogrel: Y
- Heparin: N
- Nitrates: N
- IIb/IIIa: N
- Other: pitavastatin 4mg, amlodipine 5mg, carvedilolol SR 8mg, valsartan 80 mg
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