Secondary Percutaneous Revascularization for Severe Unprotected Left Main Disease After Surgical Turndown

Konstantinos Triantafyllou, Catherine Liontou, Serafeim Liapis, Eleni Margioula, Dimitrios Stalikas, Nikolaos Sakellaris, Kostas Kappos


Patients with severe left main and/or multi-vessel coronary artery disease (CAD) and contraindications or extremely high risk for surgical revascularization that are subsequently referred for percutaneous coronary intervention (PCI) have been increasing in clinical practice. We present the case of a patient with a previous history of aortic valve replacement and coronary artery bypass grafting (CABG) hospitalized because of angina recurrence and a functional test with myocardial scintigraphy that showed extensive myocardial ischemia. The coronary angiogram revealed severe left main and two-vessel disease with totally occluded bypass grafts, while revascularization by re-do CABG was rejected. The patient was finally treated by a technically challenging high-risk unprotected left main PCI.   Rhythmos 2017;12(2):29-32.


secondary revascularization, left main disease, percutaneous coronary intervention

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