Stephane Rinfret, MD, along with operators William Nicholson, MD, Nikoloz Shekiladze, MD, and George Chang, MD, present this live case illustrating adaptability. The initial strategy to open the RCA CTO and then proceed to the LCx and first diagonal with staged PCI of the tortuous and severely calcified LAD evolved when the patient did not respond as anticipated hemodynamically.

Seth Bilazarian, MD, with panelists Brian Bergmark, MD, and Jai Khatri, MD, provide commentary for this challenging case.