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The Mount Sinai Hospital

1468 Madison Avenue, New York,
New York 10029

PCI Of Ostial LAD CTO via Retrograde Approach from RCA Collaterals


52-year-old male with COPD and OSA presented on January 31, 2020 with acute hypercarbic respiratory failure requiring intubation and ruled in with peak Troponin of 12 (Type 2 MI) and acute systolic heart failure NYHA Class IV. Patient was stabilized on medical therapy and extubated. A Cardiac Cath on February 3, 2020 revealed 1 V CAD: flush long total occlusion of ostial LAD with excellent collaterals from RCA and LVEF 48%. Patient was managed medically due to multiple medical and psychiatric issues. Patient has been compliant with GDMT with CCS Class II angina. A followup stress MPI revealed large area of severe anterior wall ischemia with partial scarring. Patient is now planned for PCI of ostial LAD CTO via retrograde approach from RCA collaterals.


Case Presentation


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