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Current Trends in Cardiology | Volume: 03
10
th
WORLD HEART CONGRESS
&
6
th
International Congress on
CARDIOLOGY AND CARDIAC SURGERY
December 02-03, Dubai, UAE
Joint event on
Curr Trend Cardiol, Volume: 03
Complex coronary artery stenting- Double bifurcation lesion intervention
Balbir Pachar, Shekhar Kunal
SMS Medical College, India
C
oronary intervention in case of acute coronary
syndrome is best, easy and promt approach for
revascularization. It maintains the perfusion of myofibrils
and thereby reverses all electrical and mechanical sequel
of ischemia. There are different types of stentotic lesion
which are revealed only after coronary angiography. These
lesions range from simple to complex and the patient
of course maybe stable or hemodynamically unstable,
imparting challenge in either way. In this case the patient
in his 80's, established case of CAD, presented with acute
coronary syndrome, hemodynamically unstable, systolic
blood pressure is 90 mmhg, on inotropic support, LVF 20-
25%, immediately shifted in cath lab for catheterization.
Angiography reveals left main + DVD. Calcified distal left
main 60%, osteal LAD 90% and osteal LCx 80% stenosed.
Immediately decided for interventions. LMCA hooked
and both vessels were wired, ballooned. When Proximal
LAD opened, there is another bifurcation lesion noted
(main branch 80%, and osteal large D1 80%). So first
distal bifurcation was tackled and then the left main
bifurcation was tackled successfully with TIMI 3 flow in
both major arteries. Subsequently patient improved and
discharged on 5th day. There is a situation during cardiac
catheterization when interventional cardiologist has to
weigh the favorable outcome of procedure against the
patient's factor I.e. age, low EF and high risk for cardiac
surgeries. In this case, interventional outcome seems to be
better against patients’ factor.
e:
bspachar1@gmail.com