[April 25] CTO LIVE_Asan Medical Center, Seoul, Korea: Case #3

- Operator : Nae-Hee Lee

1st Operator: Nae Hee Lee / 2nd Operator: Jon Suh

Brief Case Summary

A 50 year-old male was admitted for effort chest pain in other hospital. The coronary angiogram showed total occlusion at proximal LAD and significant stenosis at distal LCX. Distal LCX lesion was stented but proximal LAD lesion was failed. Then he was referred to our hospital for PCI.

Past Medical History

  • Previous MI: N
  • Previous CABG : N
  • Previous PCI: Y
  • Other: HT, DM, Current smoker

Demographic Characteristics

  • Diabetes: Y
  • Hypertension: Y
  • Hyperlipidemia: N
  • Smoking: Y
  • Family History: N
  • Age: 50
  • Sex: Male

Clinical Presentation

Stable angina

Non-invasive Studies

Echocardiography

Akinesia of RCA territory with Normal LV systolic function

Treadmill test

Not done

Thallium SPECT

Not done

Cardiac Catheterization Findings

Not done

Case Notes

Target Lesion(s)

Proximal LAD

Adjunctive Medication

  • ASA: Y
  • LMWH: N
  • Clopidogrel: Y
  • Heparin: N
  • Nitrates: N
  • IIb/IIIa: N
  • Other: Beta-blocker, ARB, statin

Teaching Points

  • Anterograde or retrograde approach of total occlusion of LAD

Coronary Angiography

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