Abstract

Double chronic total occlusion of left ascending artery proximally and right coronary artery

Author(s): Abdelaziz Ahmed Abdelaziz*

Introduction: Percutaneous Coronary Intervention (PCI) for Chronic Total Coronary Occlusions (CTOs) is a highly demanding treatment in interventional cardiology and carries a higher risk of major consequences. The operation becomes significantly more challenging with two-vessel occlusion.

Patient concerns: A male patient 53 yrs old, suffered from non-insulin-dependent Diabetes Mellitus (DM), Hypertension (HTN), dyslipidemia and had typical chest pain for the last three months on minimal exertion. The Electrocardiogram (ECG) showed ST elevation and Q wave from VI-V5 and Q wave in lead III and a vessel failure. His echocardiography revealed impaired function with Ejection Fraction (EF) 46% and regional wall motion abnormality in the Left Anterior Descending (LAD) and the Right Coronary Artery (RCA).

Diagnoses: The coronary angiography results revealed the CTO of the LAD proximally and the CTO of the RCA shortly after its ostium.

Interventions: PCI to LAD and RCA were done using implantation of 2 Drug-Eluting Stents (DES) in LAD and one DES in RCA.

Outcomes: Successful PCI to LAD and RCA using 3 DES.

Conclusion: Successful PCI to CTO LAD and RCA with implantation of 3 DES.