84-year-old female presented with new onset CCS Class III angina with positive SPECT MPI for multivessel ischemia. A Cardiac Cath on January 28, 2020 revealed 3 V CAD: 90% proximal RCA, subtotal large proximal LAD/Diagonal bifurcation lesion, 80% small LCx-OM1, SYNTAX Score of 21 and LVEF of 55%. Patient had a successful intervention of proximal RCA using Promus Premier DES. Patient is now planned for imaging guided staged PCI of LAD and D1 bifurcation using dedicated two stent (mini-crush) technique.
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