Retrograde cto ostial LAD.Post CABG.

70 y old male. occluded graft to om.
Lima is there but non functional.
only svg to diagonal was patent and giving flow to lad.
symptomatic despite of GDMT.
MPI +ve for severe reverse able ischemia in lad territory.
recurrent admissions with HF.
CTO lad attempted with AWE and RCART.
final Timi III flow.

[@mirhansyahperdana7113]

Why did you think the LAD was the culprit instead of RCA?

[@drimranhanifhashmi5442]

By MPI

[@mirhansyahperdana7113]

I think LAD got enough blood suplay from diagonal. Moreover, there was competitive flow in LIMA. Thank u

[@javieralmeidagomez8132]

It was a.mistake. The LAD graft is working perfect, so why the PCI?