JACC

Lots of interesting abstracts and cases were submitted for TCTAP 2022. Below are the accepted ones after a thorough review by our official reviewers. Don¡¯t miss the opportunity to expand your knowledge and interact with authors as well as virtual participants by sharing your opinion in the comment section!

TCTAP C-032

Biplane Angiographic Visualization System Helps in PCI Procedure.

By Konstantin Zavialov, Vladimir Plechev, Vladimir Ishmetov, Igor V. Buzaev, Vali Yunusov

Presenter

Konstantin Zavialov

Authors

Konstantin Zavialov1, Vladimir Plechev1, Vladimir Ishmetov1, Igor V. Buzaev1, Vali Yunusov1

Affiliation

Bashkir State Medical University, Russian Federation1,
View Study Report
TCTAP C-032
CORONARY - Bifurcation/Left Main Diseases and Intervention

Biplane Angiographic Visualization System Helps in PCI Procedure.

Konstantin Zavialov1, Vladimir Plechev1, Vladimir Ishmetov1, Igor V. Buzaev1, Vali Yunusov1

Bashkir State Medical University, Russian Federation1,

Clinical Information

Patient initials or Identifier Number

H27985/21

Relevant Clinical History and Physical Exam

Patient H, 62 years old, entered the Cardiology department of the BGMU clinic on October 22, 2021 with complaints of interruptions in the work of the heart, shortness of breath, intolerance physical activity. Ischemic heart disease since 2004. In 2004, CABG. RCA stenting (2011, 2018, 2019, 2021). Medication therapy: Valsartan, Warfarin, Brilinta. In October 2021 he was admitted to the BSMU clinic with stable angina 3 class. Stenosis of the internal carotid arteries on both sides is 20-25%.  

Relevant Test Results Prior to Catheterization

Creatinine before catheterization 109,1 mmol/l

Relevant Catheterization Findings

Right dominance. LCA, LCX and its branches without indications to revascularization. Left artery descending has 90% stenosis in 6 segment, in the 7 segment 95%, LAD distally without signs of meaningful narrowing (Fig. 1). The stents in the right coronary artery in 1, 2 segments without restenosis, the restenosis of the stent in the 3 segment is 70% (Fig. 2). The occlusion of the posterior ventricular artery from the ostium. Aorto-coronary bypass graft to the right coronary artery is occluded.


Interventional Management

Procedural Step

After coronarography we used guiding catheter XB 4.0 6F to left coronary artery. Coronary wire Whisper MS 0,014 "190 cm, placed in LAD, further to the distal departments. Over the coronary wire under the control of the BIPLANE visualization system, CID CRE8 2,5*20, Medtronic Resolute Integrity 3,5*38 - are implanted in the zone of left artery descending in 6-7 segments stenosis (Fig. 3). Bipane angiography helped to place the wire and position the stent precise proximally and distally without need to change the C-arch position and twice decreasing the contrast injections. Control coronarography - blood flow TIMI3 in the stenting zone, no signs of dissection, no dislocation stents (Fig. 4). Coronary wire, guiding catheter, introducer removed. Hemostasis. The patient is discharged for 3 days after the intervention Operation duration (min): 62Contrast (ml): 93 ml , Creatinine 3 days after operation 130 mmol/l

Case Summary

1. The Biplane angiography allows you to position the stent in coronary arteries simultaneously in two projections: along the distal and proximal mark of the stent.
2. Biplane does the one-time visualization of coronary arteries in two projections. But "does BIPLANE significantly decrease of contrast amount?" or "is there any difference in procedure times?" is subject to a further randomized trial.
3. BIPLANE coronary angiography and PCI are useful for simple or complicated cases. It is an important step in training specialists on simple cases first to be ready for more complicated situations.