Complications of PTCAComplications of PTCA

SAGIC Meeting AlexandriaSAGIC Meeting Alexandria

28th June 200528th June 2005

A. B.A. B.

45 yr old Yamani gentleman with exertional C/P 45 yr old Yamani gentleman with exertional C/P and SOB 0f 3 yr durationand SOB 0f 3 yr durationCADRF Age, Gender, Diabetes, ex smokingCADRF Age, Gender, Diabetes, ex smokingNormal examNormal examECG with poor progression of R wavesECG with poor progression of R waves2-D Echo March 2004 LVEF 20%2-D Echo March 2004 LVEF 20%Dobutamine stress Echo improvement in wall Dobutamine stress Echo improvement in wall motion in inferolateral areas, and mild motion in inferolateral areas, and mild improvement in anteroseptal areaimprovement in anteroseptal areaSCA May 2004 100% proximal RCA, and 100% SCA May 2004 100% proximal RCA, and 100% osteal LAD osteal LAD

June 2004June 2004

PTCA to chronic RCA occlusionPTCA to chronic RCA occlusion

Started with BP 100/50mm Hg.Started with BP 100/50mm Hg.

With 1With 1stst angiographic shot, Drop BP, angiographic shot, Drop BP, Inotropes, IABP with long complex PTCA / Inotropes, IABP with long complex PTCA / stenting DLC coated stentstenting DLC coated stent

2 Days in Hospital2 Days in Hospital

Post PTCA LVEF 40% Post PTCA LVEF 40%

MAY 2005MAY 2005

LCA PRE PTCALCA PRE PTCA

Wires into diagonalsWires into diagonals

Contralateral RCA injectionContralateral RCA injection