Lots of interesting abstracts and cases were submitted for TCTAP 2023. 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-170
Again and Again
By Chun-Wei Lee
Presenter
Chun-Wei Lee
Authors
Chun-Wei Lee1
Affiliation
Mackay Memorial Hospital, Taiwan1,
View Study Report
TCTAP C-170
IMAGING AND PHYSIOLOGIC LESION ASSESSMENT - Physiologic Lesion Assessment
Again and Again
Chun-Wei Lee1
Mackay Memorial Hospital, Taiwan1,
Clinical Information
Patient initials or Identifier Number
50268235
Relevant Clinical History and Physical Exam
55 y/o M came with chest pain and cold sweating since 2 hours ago.Underline hypertension, heavy smoker 3-4PPD for 35+ years, COPD and hyperlipidemia.ECG showed anterior lead ST segment elevation myocardial infraction.
Relevant Test Results Prior to Catheterization
ECG showd anterior lead ST elevation
Relevant Catheterization Findings
Interventional Management
Procedural Step
We first rey to do the thrombosuction in LAD.However, during the precudure, No-reflow phenomenon attacked. We used adenosine but sudden bronchospasm and shock attacked.After intubation and inotropic agent, the patient regain TIMI 3 flow in LAD with some dissection in LAD.Initially, the patient decided to receieved CABG.However, another episode of chest pain with hypotension attacked.Emergency CAG was performed, the patient decided to change his mind and will receieved PCI.We placed a DES in LAD(IRA), and used iFR for LCX and RCA.RCA showed insignificant iFR(0.95) value and LCX iFR value showed significant(0.75). W ethen placed a DES in LCX.
32 LAD stent 後.avi
43 LCX stent 後.avi
53.avi
32 LAD stent 後.avi 43 LCX stent 後.avi 53.aviCase Summary
Function test can still be useful in ACS especially when we need to decided whether it is a "true TVD" or not.For those who are not able to tolerate adenosine such as bradycardia, allergic to medication or bronchospasm patients, iFR is an effective way for function evaluation.