CASE & Plan:
69-year-old male with cirrhosis presented with CCS Class III angina. A Cardiac Cath at OSH on December 27, 2022 revealed extensive 3 V CAD: multiple calcified RCA lesions with ISR of RPDA and RPL1, trifurcation lesion of 90% proximal LAD, 90% LAD-D1, 70% proximal LCx-OM1, 80% Ramus with SYNTAX Score of 39 and LVEF 60%. After Heart Team discussion, CABG was declined due to liver cirrhosis and recommended high-risk multivessel PCI. Patient underwent successful PCI of multiple RCA lesions using three Xience Skypoint DES and did well. Patient is now planned for imaging guided complex PCI of LAD/LCx/Ramus trifurcation.