CORONARY - Bifurcation/Left Main Diseases and Intervention
Intravascular Ultrasound (IVUS) Guided Left Main and Anterior Descending Intervention
Seng Hsiung Toh1, Chong Loong2, Houngbang Liew1
Queen Elizabeth II Hospital, Malaysia1, Serdang Hospital, Malaysia2,
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
58 years old gentleman, with no previous medical illness, non-smoking, with a family history of ischemic heart disease, presented to a non-PCI abled district hospital for Non-ST Elevation Myocardial Infarct in May 2019. He was electively admitted in August 2019 for coronary angiography. New York Heart functional class I, Canadian Cardiac Society functional class I, SYNTAX score 28, and ACR-HBR low risk. Blood pressure 114/78 mmHg and heart rate 78 beats per minute.
Relevant Test Results Prior to Catheterization
Creatinine 90 umol/L.Hemoglobin 13.3 g/dL.Platelet 243 x 109/L.Creatine kinase 800 IU/L.Electrocardiogram in August 2019 showed resolved ST segment depression in leads V3-6.Echocardiography showed left ventricular ejection fraction of 45-50%.
Relevant Catheterization Findings
Intravascular Ultrasound (IVUS) guided Left Main Coronary Artery (LMCA) intervention, as highlighted in the European Bifurcation Club’s Consensus, has several benefits such as 1) enabling proper sizing of vessel and stent, 2) determining stent landing area, 3) post procedural stent optimization, and 4) statistically is associated with a reduction in all-cause mortality, target lesion restenosis, and in-stent restenosis.