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Acute coronary and cerebrovascular syndrome

1. University Heart Center, Department of Cardiology, University Hospital Zürich, Zürich, Switzerland; 2. Department of Angiology, University Hospital Zürich, Zürich, Switzerland



A 78-year-old patient with a history of coronary artery bypass grafting, percutaneous coronary intervention and transcatheter aortic valve implantation (Panel A, THV) was admitted with crescendo angina, dizziness, left arm fatigue and elevated troponin. An angiogram (Panel A) showed chronically occluded right (RCA) and left (LCA) coronary arteries and a chronic in-stent occlusion of the vein graft (V-RCX) to the marginal branch. The left internal mammary graft (LIMA) to the left anterior descending artery could not be intubated because…

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