A 70-year-old male with a past medical history of hypertension and chronic obstructive pulmonary disease (not on oxygen) presented to the emergency room with complaints of shortness of breath of 3 months duration. Shortness of breath was gradual in onset and progressive in nature and associated with intermittent vague chest pain. He denied associated diaphoresis and nausea but admits to pedal edema and 3 pillow orthopnea. Physical exam was remarkable for the obese male not in acute distress. Bibasilar crackles were noted. 2 + pitting pedal edema. JVD was also noted. The patient was admitted to medicine. Iv Furosemide 60 mg iv was started. The next day 2D echocardiogram was done which revealed anterior wall motion abnormalities. Cardiology was consulted. The patient subsequently underwent cardiac catheterization which revealed a heavily calcified lesion involving ostial to mid part of the left anterior descending artery. An attempt at stent placement was unsuccessful. A decision to proceed with rotational atherectomy was done. What would be the optimal rotational speed for rotational atherectomy and the duration of ablation during each pass through the coronary artery?
A. 100,000 rpm and 20 to 30 seconds B. 150,000 rpm and 20 to 30 seconds C. 220,000 rpm and 45 seconds D. 100,000 rpm and 60 seconds Click the button below to view answer:
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