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1. Right femoral arterial access
2. Selective coronary angiograms
3. PTCA/stent 3.0 x 28 mm bare-metal stent proximal RCA
for final reference diameter 3.30 mm
4. PTCA/stent mid RCA with 3.0 x 12 mm bare-metal stent
final reference diameter 3.30 mm
5. Left heart catheterization
6. Intra-aortic balloon pump placement
1. Chest pain 2. STEMI
Less than 50 mL
SEDATION: Conscious local
DESCRIPTION OF PROCEDURE: Informed consent obtained from the patient.
Written informed consent obtained from patient. Provided risk of procedure
to include but not limited to bleeding, infection, hematoma, deep venous
thrombosis, pulmonary embolism, limb or organ dysfunction, limb loss,
kidney failure, permanent dialysis, stroke, arrhythmia, myocardial infarction,
allergic reaction, respiratory complication, death. The patient was aware of
risk and agreeable to proceed. The patient brought to catheterization
laboratory, attached to continuous monitoring oxygen saturation, blood
pressure, heart rhythm. The patient prepped sterile fashion. Right groin
anesthetized 1 percent Xylocaine. Using modified Seldinger technique,
micropuncture kit used to obtain access to right common femoral artery,
upsized 7-French sheath, properly aspirated and flushed. JL-4 diagnostic
catheter used to engage left coronary artery. Selective angiogram
performed. This exchanged over the wire for JR-4 guide catheter 6-French
used to engage right coronary. Selective angiogram performed in multiple
views as well. Next, BMW wire was attempted to pass the RCA occlusion;
however, this was not possible so this was exchanged for a pilot wire which
successfully negotiated past the occlusion. Angiogram performed and wire
placement was confirmed. A 2.5 x 12 balloon used to perform inflation in the
proximal RCA. This was removed. Subsequent angiograms demonstrated

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