XX yo male, female with hx CAD s/p PCI to XX, DM, HTN, dyslipidemia, and smoking presents for evaluation of SOB, chest pain, positive stress test in the XX distribution. LVEF noted to be XX%.

Right heath catheterization performed though 7-F RFV sheath:
RA mean was: XX mmHg
RV pressure was: XX mmHg
PA pressure was: XX mmHg
PAOP mean was: XX mmHg
Fick CO/CI was:
Thermo CO/CI was:
PVR was: XX Wood Units
SVR was: XX Metric Units

Procedure performed though 4-F RFA sheath with JL4 and 3DRC catheters.
LM: Large and bifurcates into the LAD and LCx. There are no significant stenoses.
LAD: Large, giving 2 large diagonal branches before terminating as a Type III vessel (wrapping around the apex). There are no significant stenoses in the LAD, D1, or D2.
LCx: Large and gives 2 large OM branches before continuing and terminating in the left AV groove. There are no significant stenoses in the LCx, OM1, or OM2.
RCA: Dominant, it gives 3 moderate-sized RV marginals and continues to the RPAV. It branches into the RPDA and 3 moderate-sized RPLAs. There are no significant stenoses in this system.

Sheath was removed in cath lab. No complications were observed.

Recs:
Bedrest for 2 hours.
Explore noncardiac causes of chest pain.
Continue primary prevention strategies.
Plan to d/c home after bedrest complete and to followup with the referring physician.
After adequate anticoagulation with heparin, an XB3.5 guide was placed in the left main coronary artery. A BMW wire was advanced into the distal LAD without difficulty. The lesion was then predilated with a 2.0x12mm compliant balloon catheter. A 3.5x15mm everolimus-eluting stent was then deployed in the lesion at XX atm for XX seconds. Post-implantation imaging revealed no dissection, perforation, or other complications and the stent balloon was removed. A 4.0x8mm noncompliant balloon was then used to postdilate the stent at XX atm for XX seconds and then removed. Postdilation imaging revealed no dissection, perforation, or other complications and the NC balloon was removed. The wire was then removed and imaging obtained in orthogonal views showed no observed complications.

Recs:
Admit for overnight observation.
Sheath removal when ACT <150.
Bedrest for 4 hours after sheath is removed.
Aspirin indefinitely
Clopidogrel at least 12 months without interruption.
Maximize secondary prevention strategies with beta blockade, ACE-inhibition, and statin therapy.
Plan to d/c home if no complications overnight.
Diagnostic Report (Comments Section)
Interventional Report (PTCA Section)