Video : Live Case #3 : Tentative de recanalisation de l’artère circonflexe avec échec et angioplastie du pontage saphène vers la première marginale

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Cardiology / Coronary / Cto / Case in the box

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73 ans- Référé par son médecin traitant pour dyspnée exacerbée (NYHA III/IV)
ATCD médicaux
- Cardiomyopathie ischémique – SCA inférieur (1984) avec ATC coronaire droite
- M3Vx (2005)
- PMC-G sur l’IVA, SVG-CD, SVG-marginale
- FAC anticoagulée
- Dyslipidémie, hérédité, surcharge pondérale, diabétique non insulino-traité
- MVAS périphérique (en attente de revascularisation)
Échographie cardiaque de repos
- FeVG 25-30%, DTDVG 68 mm, akinésie inféro-latérale, hypokinésie antéro-septale
- IM ¼
- VD non dilaté, hypokinétique, IT minime
Biologie
- Hb 15.8 g/l, Plt 293.000, Créat 17.1 mg/l (ClCr 39 ml/min), ProBNP 964 pg/ml, Tropo 20 mg/l
Traitement médical
- Eliquis 5 mg BID, Lasilix 40 mg BID, Entresto 49/51 mg OD, Tahor 40 mg OD, Nebivolol 2.5 mg OD

Shooting date : 2018-04-12
Last update : 2018-05-22