2009 CIT CASE REVIEW
Li Weijie Department of Cardiovascular Medicine, Xijing Hospital
Case 1 History (2009-3-21)
Male, 55 years old
Complain: Paroxysmal chest distress with palpitation for 3 years Aggravated for 3 months
Past history: HypertensionStents (Cypher) implantation at RCA 2-3 and 4PD (2008-12)
Diagnosis
1. Coronary artery disease
Unstable angina pectoris
Old inferior myocardial infarction
NYHA class I
2. Stage 2 hypertension
ECG
Old inferior myocardial infarction
Ultrasound
Ejection Fraction 60%
Coronary angiography
RCA2 25%; 4AV ostial 90%; RCA2-3, 4PD Free of in-stent restenosis
LAD6 99%; LAD7 100%; LCX12 80%; LCX13 25%; LCX15 50%
Coronary angiography
LAD6 99%;
LAD7 100%;
LCX12 80%;
LCX13 25%; LCX15 50%
Coronary angiography
Collateral Circulation
Retrograde wire
Runthrough FielderMicro-catheter
M3
Forward wire
Fielder
Confirm the true luminal
Stents implantation
2.75mm×33mm FIREBIRD 3.0mm×23mm FIREBIRD
Coronary angiography
Follow up (2010-3-18)
Complain: Mild chest distress
UCGEF 55%
ECGOld inferior myocardial infarction
Coronary angiography
LAD6-8 Free of in-stent restenosis; LAD8 25%; LAD9 90%; LAD10 95%; LCX12 100%; LCX14 95%; LCX15 50%
Coronary angiography
RCA1 25%; RCA2 25%; 4AV ostial 90%;RCA2-3, 4PD Free of in-stent restenosis
Balloon dilation
2.5mm×20mm
Stent implantation
LCX13-14 2.75mm×29mm FIREBIRD2 14ATM 15s
Finall results
Intramural hematoma
Case 2 History (2009-3-21)
Male, 55 years old
Complain: Paroxysmal chest distress with
short of breath for 2 months
Diagnosis: Coronary artery disease
Unstable angina pectoris
ECG
Sinus rate 76 bpm, normal ECG
Coronary angiography
LMT 5 30%;LAD 6 ostial 90%; LAD 9 75%
LCX OM3 50%; LCX 15 75%
Coronary angiography
RCA 2 30%; RCA 3 50%; 4PD ostial 75%
Guiding 7F EBU 3.5
BMW Rinato Runthrough 2.5mm×29mm Firebird
Stent implantation
LCX13-15-OM3 2.5mm×29mm Firebird 16ATM 7s 18ATM 7s
2.5mm×13mm Firebird 2.0mm×20mm balloon
3.5mm×23mm Firebird 2.0mm×20mm balloon
3.5mm×20mm 10ATM 2.5mm×20mm 10ATM
Follow up
• Suesequent visit: the patient feel well, no complaint,no symptom
• Unwilling to subsequent CAG