A Report of Successful Procedural, Clinical, and Angiographic Outcomes with a Tapered Stent of a Patient in Naturally Tapered Coronary Vessel

A 67-year-old male patient presented with the symptoms of class II-III angina (as per Canadian Cardiovascular Society Grading System), i.e., chest heaviness and shortness of breath on exertion for six months.Two weeks prior to the presentation, his treadmill test was tested positive, elsewhere.He was admitted to our hospital for further management.He was a known case of chronic rheumatic heart disease with mild mitral stenosis and was suffering from diabetes for past 15 years.At the time of presentation, his blood pressure was 140/80 mmHg and the pulse rate was 94 beats/min.Physical examination of the patient revealed clear chest and mild diastolic murmur.All haematological and biochemical tests were within normal ranges.Electrocardiogram revealed normal sinus rhythm.Other laboratory examinations were within normal ranges.Subsequently, coronary angiography was performed through transradial approach using 5F Tiger catheter.It revealed two tandem lesions in Left Anterior Descending (LAD) artery, 90% lesion in mid LAD and 95% lesion after third diagonal (D) branch, with ostio-proximal tight lesions in D2 and D3 .Further, there was 90% stenosis in mid Left Circumflex (LCX) artery and 90% stenosis in distal Right Coronary Artery (RCA), with mild irregularities in Posterior Descending Artery (PDA) and Posterior Left Ventricular Branch (PLVB).The patient was diagnosed with triple-vessel disease.Patient was advised for Coronary Artery Bypass Grafting (CABG) with mitral valve reconstruction or triple vessel stenting with medical management for mitral stenosis.Treatment options were discussed with the family.The patient and his family opted for triple vessel stenting.