Case AQ019

Question AQ 019

The cineangiograms of the patient's left and right coronary angiograms and the left internal mamary artery (LIMA) graft to the left anterdior descending (LAD) are shown below. You can cycle through the various cine views by clicking the "next cine" and "prior cine" buttns. The latter button will appaer after you move to the second cine.

[ Click Here to ENLARGE the image size ]

FOR AUDIO: Click the Speaker Icon to "unmute" Audio

Please answer the question AFTER you have reviewed ALL five views.
Which ONE of the following BEST describes would you expect to see in the next angiogram of the reversed saphenous vein graft (SVG) to the right coronary artery (RCA)?

A. Totally occluded SVG to RCA

B. Significant stenosis in SVG to RCA (or native RCA) with collaterals to the circumflex (Cx)

C. Significant lesion in SVG to RCA (or native RCA) without collaterals to the Cx

D. Total occlusion of the RCA, distal to the graft anastamosis

E. Hemodynamically insignificant lesion in the SVG to RCA

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