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Figure 2 Diagram of the coronary artery tree (upper panel) and myocardial perfusion polar map displays (lower panel) of a patient with three-vessel CAD (coronary artery jeopardy score = 10) and severe LV dysfunction (NYHA functional class 2, LVEF 20%). On the baseline study, large moderate uptake defects are observed in the anterior and inferior wall, with clear increase in sestamibi activity on the nitrate study. The patient was refused by the surgeon for technical difficulties in performing CABG and for the high risk associated with the procedure. Therefore, the patient underwent successful PTCA on LCX (left circumflex artery), and on RCA (right coronary artery), whereas the LAD (left anterior descending) could not be treated. The patient had regional and global functional recovery (LVEF 40%), with disappearance of effort dyspnea, but died because of sudden death seven months after PTCA.
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