GUIDELINER CATHETER PPT FREE

This could not be conclusively identified on the cardiac catheterization. A 10-cm segment of the guidewire distal to the burr was seen perforating the LAD and exiting into the pericardium ( Figure 2, A and B). Redo sternotomy was performed and saphenous vein was harvested. Troponin-I levels had increased from an initial postcatheterization value of 0.01 ng/mL to a final preoperative value of 5.31 ng/mL (normal reference range, 0.00-0.03 ng/mL). A computed tomography scan of her chest was performed to prepare for redo sternotomy, and she underwent an operation for its retrieval. She had received a loading dose of clopidogrel a few hours before the start of the catheterization and was initiated on a heparin drip. Electrocardiogram showed normal sinus rhythm with no ST changes or T wave abnormalities, and left ventriculogram suggested a normal ejection fraction with normal wall motion.

GUIDELINER CATHETER PPT FREE

At the time of consultation, the patient was hemodynamically stable and free from chest pain. At this point, the cardiac surgical service was called. Additional catheter-based techniques were used, namely introduction of a second guidewire with attempted angioplasty of the stuck segment, but the segment could not be crossed with the second guidewire due to resistance at this site. After initial advancement of the burr through the lesion, pulling back did not permit its removal ( Figure 1). Because it was calcified, rotational atherectomy was performed through a femoral artery (Rotablator Boston Scientific, Marlborough, Mass).

The mid-LAD lesion was distal to the failed internal thoracic artery-LAD bypass.

She also had prior drug-eluting stent placement to the proximal and mid-LAD, with 40% in-stent stenosis in the proximal LAD, and 95% in-stent stenosis in the mid-LAD ( Figure 1, A). She had undergone coronary artery bypass grafting 8 years ago, and recent catheterization showed an atretic left internal thoracic artery to LAD bypass, as well as patent vein grafts to a diagonal branch and right coronary artery. A 81-year-old woman underwent cardiac catheterization for angina due to a left anterior descending (LAD) calcified in-stent stenosis.

Guideliner catheter ppt