1st Operator: Seung-Whan Lee / 2nd Operator: Chang Hoon Lee / 3th Operator: Gyeong-Min Park

A 57 year-old male was admitted for the evaluation of coronary CT angiography abnormality. The coronary angiography was performed which revealed significant stenosis at proximal to mid LAD and total occlusion at proximal RCA. Then, proximal to mid LAD lesion was stent implanted.

• Previous MI: N

• Previous CABG : N

• Previous PCI: Y

• Other: h/o CVA, current smoker

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

• Smoking: Y
• Family History: N

• Age: 57
• Sex: Male
• Other: h/o CVA

Silent ischemia

Echocardiography

Akinesia of inferoposterior wall with normal LV systolic function (EF 54%)

Treadmill test

Negative

Thallium SPECT

Not done

• The coronary angiography showed total occlusion at proximal RCA with grade 3 collateral flow from OM.
• Significant stenosis of proximal to mid LAD was also shown.
• SYNTAX score: 28

Target Lesion(s)

Proximal RCA

• ASA: Y
• LMWH: N

• Clopidogrel: Y
• Heparin: N

• Nitrates: N
• IIb/IIIa: N

• Other: Beta-blocker, statin

• Anterograde or retrograde approach of total occlusion of RCA