, Hee Hwa Ho1 and Paul Jau Lueng Ong1
(1)
Department of Cardiology, Tan Tock Seng Hospital, Singapore, 308433, Singapore
(2)
Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019 Auckland, New Zealand
Electronic Supplementary Material
The online version of this chapter (https://doi.org/10.1007/978-3-319-60490-9_14) contains supplementary material, which is available to authorized users.
Case Summary
A 68-year-old man with diabetes mellitus, hypertension, chronic kidney disease, hyperlipidemia, and peripheral arterial disease was admitted for non-ST-elevation myocardial infarction. He had known CAD and had previously undergone PCI to the mid- and proximal LAD on separate occasions.
Coronary angiography showed extensive calcification. There was severe stenosis of the distal LM extending into the proximal segments of both the LAD and LCX coronary arteries (Figs. 14.1 and 14.2, Videos 14.1 and 14.2). The first diagonal was occluded. The RCA was also heavily calcified with moderate to severe diffuse disease (Fig. 14.3, Video 14.3). The calculated Syntax score was 33. An intra-aortic balloon pump was inserted and he was referred for urgent CABG.
Figure 14.1
PA Cranial view of left coronary system. Note: the critical proximal LAD disease
Figure 14.2
LAO Caudal view of left coronary system. Note: critical LM bifurcation disease (Medina 1,1,1)
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