Slides
Ostial LM Disease
- Operator : Patrick W. Serruys
Ostial LM Disease |
- Operators: Patrick W. Serruys, Chieng Chen Wu |
Clinical presentation |
A 51-year old man was suffered from effort-related chest pain for 1 month. So, he visited our hospital and got coronary angiography. That coronary angiogram showed ostial left main coronary artery disease. He had no history of MI, CABG or PCI. His coronary risk factors were diabetes, hypertension, hyperlipidemia and smoking. Baseline ECG showed normal sinus rhythm. Echocardiography revealed no regional wall motion abnormality and normal LV systolic function. Thallium SPECT showed normal perfusion. |
Baseline coronary angiogram |
1. Left coronary angiogram showed 70% narrowing
of ostial LM (Figure
1) |
Procedure |
A 7Fr sheath was inserted into the right femoral artery, and the left coronary ostium was engaged with a 7Fr JL guiding catheter with 4.0cm curve. A 0.014 inch BMW wire was inserted into the LAD. IVUS study was done about ostial LM disease. IVUS findings revealed heavy plaque burden in the ostial LM (Figure 2). Initially, we planned direct stenting with 4.0 X 12mm Taxus liberte stent at ostial LM (Figure 3, Figure 4). And then we performed post-stent balloon dilatation with Quantum 5.0 X 8mm (Figure 5). IVUS study was performed. IVUS findings showed good position & well expansion of the ostial LM stent (Figure 6). Final left angiogram showed that the procedure was successful (Figure 7). |
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