CTO Course - Case 1 -...
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Case 1Clinical Data
• 1998: NSTEMI
• CABG in 1998 – 2 internalmamary arteries – LAD and RCA
• Reoperated in 1999 due to occlusion of both grafts – 2 new
venous grafts to LAD and RCA
Case 1Clinical Data
• 2009: New coronary angiogram in the setting of symptomatic
stable coronary disease
• RCA venous graft occluded
• New severe stenosis of circunflex artery
• PCI with 2,25 x 28 mmDES
Case 1Clinical Data
• Unknown data: 3rd coronary angiogram in the setting of
symptomatic stable coronary disease
• Stenosis of LAD venous graft – successful PCI with DES
Case 1Clinical Data
• 2016: 4th coronary angiogram
• Myocardial Perfusion Test: extensive anterior and inferior
ischemiawithout necrosis
Case 1Clinical Data
• 2016: 4th coronary angiogram
• Coronary Angiogram
• Restenosis of LAD venous graft stent – PCI with new 3 x
24 mmDES
• Consideration of PCI of the RCA and LAD Chronic Total
Occlusion