I am presenting a case of 79 years old gentleman who was diagnosed as a case of evolved inferior wall myocardial infarction with complete heart block and shifted to our hospital for PCI. His pulse rate was 48/minute and BP was 86/60 mmHg. He was a known case of hypertension on irregular treatment.
12 leads ECG showed evolved inferior and lateral wall infarction with Mobitz type I AV block.
Echocardiogram showed basal and mid inferior, posterior and lateral wall hypokinesia with moderate mitral regurgitation and left ventricleEF= 35%.
CAGLMCA- long, distal plaqueLAD- diffusely diseased, 90-95% stenosisLCX- nondominant and has proximal significant diseaseRCA- severely calcified showing tram track calcification and occluded distally 2_mpeg4.avi 3_mpeg4.avi
It was a case encountering triple vessel disease with severely calcified right coronary artery occluded by thrombus in acute ST-elevation MI patients.The lesion was crossed by the CTO wiring technique using a pilot 150 wire with a microcatheter.Distal vessel calcification guides us to cross the lesion.Extra guiding support was taken by a Guidezilla from the starting of the procedure which helps to deliver large balloons and stents.In these types of primary angioplasty, we have to follow the steps of the CTO technique.