Lots of interesting abstracts and cases were submitted for TCTAP 2024. 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-115
The Sailor in the Deep Sea
By Shariful Islam
Presenter
Shariful Islam
Authors
Shariful Islam1
Affiliation
Zia Heart Foundation & Intervention Center, Bangladesh1,
View Study Report
TCTAP C-115
Coronary - Complication Management
The Sailor in the Deep Sea
Shariful Islam1
Zia Heart Foundation & Intervention Center, Bangladesh1,
Clinical Information
Patient initials or Identifier Number
Relevant Clinical History and Physical Exam
PATIENT’S INFOSex: MAge: 50 years
RISK FACTORSHypertensive
RISK FACTORSHypertensive
PRESENTING COMPLAINTS
CCS Class III angina
H/O NSTEMI
Chest pain
Hypotension
Bradycardia
Saturation falling
VT
VF
CPR started immediately
INVESTIGATIONS
Echo:
No RWMA
LVEF-56%
Relevant Test Results Prior to Catheterization
Relevant Catheterization Findings
Interventional Management
Procedural Step
Quick wiring of LAD & LCX
Hematoma in LM ostium
Dissection flap in LAD ostium
Hematoma in prox LAD
IVUS in LAD to LM
Prevention:
Do NOT inject if pressure dampened
Coaxial guide
Gentle wiring
Avoid oversized balloons + high inflation pressures
Prepare calcified lesions
1. Stenting done Ostio proximal LM to Proximal LAD with Xience Xpedition 3.5 X 23 mm DES @ 10 ATM
2. Post dilatation of distal stent with 3.5X23 mm SC stent balloon
3.POT with NC Mozec 4.5 X 10 @ 16-20 ATM
4. IVUS after stenting
5. Good stent expansion
Case Summary
latrogenic LM dissection can be managed successfully percutaneously and prevents delay in restoring flow compared to conventional open-heart surgery.
Percutaneously managed LM dissection has a similar survival compared to surgically managed individuals.*
Avoid deep engagement of guide & continuously monitor the tip of the guide so that it is not sucked in.
Do not keep the guide too long in deep engagement position inside the LM.