Imaging Guided RotaTripsy DES of Large Calcific Nodule in Distal LM/LCx 

Case Plan
72-year-old obese female with crescendo angina and dyspnea was found to have severe AS on echo. A Cardiac Cath on April 9, 2024 revealed calcific 3V + LM CAD with large calcific nodule of distal left main, SYNTAX Score of 44 and EF 55%. Patient underwent CABG (LIMA for LAD, RIMA to Diagonal) and bioprosthetic SAVR and subsequently did well. Additional bypasses could not be done due to calcific aorta (‘Eggshell’). Patient continued to remain symptomatic with CCS Class II angina and DOE. Patient is now planned for imaging guided RotaTripsy DES intervention of residual large calcific nodule in distal LM/LCx.