Slides

LM and Bifurcation Lesion with Crossover

- Operator : Alan C. Yeung

LM and Bifurcation Lesion with Crossover
- Operators: Alan C. Yeung, MD, Chieng-Jen Wu, MD
Clinical Information

- Relevant clinical history and physical exam:
A 65-year-old man was admitted with dyspnea on exertion for 5month and abnormal thalium spect. ECG showed nonspecific, and biomarker was within normal range.

- Relevant test results prior to catheterization:
Echocardiography showed normal LV systolic function without regional wall motion abnormality
Thalium spect showed reversible large sized defect in LCX territory

- Relevant angiography findings:
Coronary angiogram showed the severe stenosis from left main to middle LAD with heavy calcification.(Figure 1)
Interventional Management
- Procedural step:
A 8Fr sheath was inserted into the right femoral artery, and the left coronary ostium was engaged with a 8Fr XB guiding catheter with 3.5cm curve. A 0.014 inch BMW wire was inserted into the LAD and the LCX respectively. Left main to proximal LAD lesion were predilated with 3.0 X 15mm Maverick balloon. And then The Taxus liberte stent 3.0 X 38mm stent was deployed at pmLAD.(Figure 2) Post-stent ballooning with Quantum 3.5 X 15mm was done. We also deployed Endeavor resolute 4.0 X 18 mm at left main with a distance from Taxus stent to avoid crossing the LCX.ostium(Figure 3) And then poststent ballooing with Quantum 4.0 X 8mm was done several times. Gap between 2 stents was noted via IVUS and Angiogram. Final left angiogram showed that the procedure was successful.(Figure 4)

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