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C/O Chest pain, sweating, associated with generalized weakness since 10 days, symptoms increased 1day prior to admission.Diagnosis – : CAD/ACS/ACUTE AWMI/SEVERE LV SYSTOLIC DYSFUNCTION/LVEF=30%/MILD MR ECG- Acute anterolateral infarct 

Left Main with Single Vessel Disease, Left Main: Distal 70-80% disease. LAD: Ostial 100% occlusion.LCX: Nondominant, Normal.OM1 & OM2: Normal.RCA: Super dominant, Normal.PDA/PLV: Normal. 

Left Coronary Artery : was engaged with JL 3.5, 6F guide catheter. A 0.014” SION BLUE wire was used to cross the Left Main to LAD lesion. Pre dilatation done with SC Sapphire Balloon 2.0 10 mm @ 12atmosphere. Drug Eluting Stent XIENCE PRIME LL 3.5 38 mm deployed in proximal LAD @ 12atmosphere and another Drug Eluting Stent RESOLUTE ONYX 3.5 18 mm deployed in Left Main to LAD  

Left Coronary Artery : was engaged with JL 3.5, 6F guide catheter. A 0.014” SION BLUE wire was used tocross the Left Main to LAD lesion. Pre dilatation done with SC Sapphire Balloon 2.0 10 mm @ 12atmosphere. Drug Eluting Stent XIENCE PRIME LL 3.5 38 mm deployed in proximal LAD @ 12atmosphere and another Drug Eluting Stent RESOLUTE ONYX 3.5 18 mm deployed in Left Main toproximal LAD @ 14 atmosphere. Overlapping the proximal stent. Post dilatation done with NC SapphireBalloon 3.5 10 mm @ 14 atmosphere in LAD and NC Sapphire Balloon 4.0 10 mm @ 16 atmosphere inLeft Main. GP IIb IIIa inhibitor was used during the procedure. Excellent result with TIMI III flow.Successful PTCA with stenting to Left Main to LAD 
LEFT MAIN TO LAD (CTO) &.pptx

Percutaneous intervention with stent implantation for LMCA disease has become a standard procedure in contemporary practice with safety, expedited recovery, and durability. Precise selection of the strategy aided by intracoronary imaging, functional evaluation, and mechanical support when needed have improved the immediate and long-term results in this high risk intervention. It is however important to have a team approach and operator expertise before embarking on LMCA interventions