Complex PCI with Multiple Comorbidities
Dr. Tanveer Rab of Emory University joins Dr. Cathy Jeon to discuss a case of an 80 year old male with a low ejection fraction of 30% and very complex coronary artery disease who was deemed to be too high risk for CABG. The comorbidities included chronic kidney disease, diabetes on insulin, and hyperlipidemia. The angiogram showed a calcified left coronary system with distal left main, ostial LAD, and mid-circumflex disease. The right coronary artery was calcified with discreet stenosis in the mid portion of the vessel. The team calculated the Syntax I score to be 47, yet the STS score showed a risk of mortality with valve replacement at 27% with a risk of morbidity or mortality during surgery of 66%. The case therefore was referred to the heart team, and ultimately the team and the patient’s family opted for a Protected PCI with total revascularization as the goal.
Tune in to watch the results of this high risk PCI with hemodynamic support.
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