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Case summary

•79 year old female patient
•No significant medical past history
•Presented with stable angina
•Myocardial perfusion imaging revealed a large anterior perfusion defect
•Transthoracic echo :
           -EF: 60%
           -No valvular heart disease
•Coronary angiography


•Syntax I score : 28
•Syntax II score :
-PCI : 37.9 (PCI 4-yr mortality 12.8%)
-CABG : 34.5 (PCI 4-yr mortality 9.7%)
Recommandation: CABG or PCI
•Patient preferred PCI option, Heart team in agreement
Planned PCI strategy
           -Pre-intervention IVUS evaluation of LAD lesion and LMS trifurcation
           -PCI of LAD and LCx lesions if required
           -PCI of LMS trifurcation lesions (provisional or 2-stent technique)
           -IVUS to evaluate/optimize the PCI result