Coronary April 2018

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The Mount Sinai Hospital

1468 Madison Avenue, New York,
New York 10029

Complex PCI in the setting of Severe AS

Miscellaneous Coronary

87 year old male with known aortic stenosis and moderate pulmonary hypertension presented on March 19, 2018 with NSTEMI (TnI of 2.0) and acute diastolic heart failure. A Cardiac Cath on March 20, 2018 revealed 3 V CAD: 80% calcified proximal LAD/Diagonal bifurcation (Medina 1,1,1), 90% thrombotic distal LCx, 70% proximal RCA with normal LV function and SYNTAX Score of 24. Patient improved rapidly on medical therapy and a follow-up echo revealed severe AS with PG/MG/AVA/PV: 110/82/0.3/5.2. Patient is now planned for iFR guided multi-vessel PCI of LAD/D1 bifurcation, distal circumflex and BAV as prelude to planned TAVR procedure after one month.


Case Presentation


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