AUDIT REPORT CARDIAC CATHETERIZATION REPORTLOCATION: Inpatient, HospitalPATIENT: Matthew LoganATTENDING PHYSICIAN: Leslie Alanda, MDSURGEON: James Noonar, MDPROCEDURES PERFORMED: Right and left coronary angiogram, LV-gram left heart.INDICATION: Unstable anginaHEMODYNAMICS:1. Aortic pressure is 142/74.2. LV pressure is 142/20 with no gradient on pullback.VENTRICULOGRAM: Ventriculogram showed normal LV size. There is an inferiorwall hypokinesis with an ejection fraction of 55%.CORONARY ANGIOGRAM:RIGHT CORONARY ARTERY: The right coronary artery is totally occluded in itsproximal third. There is a large stent deployed from the proximal right coronary artery allthe way close to the distal third that has in-stent restenosis with total occlusion and withTIMI-0 flow, and preobstructive collateral from the conus branch filling and the distalright coronary artery.LEFT MAIN CORONARY ARTERY: The left main is normal.LEFT ANTERIOR DESCENDING ARTERY: The left anterior descending artery has inits proximal third plaque that appears to be eccentric and severely obstructive. The leftanterior descending artery thereafter has no significant disease. It gives rise in themidportion to a small diagonal that has no significant obstruction.CIRCUMFLEX ARTERY: The circumflex artery as rises from the left main istrifurcate. The first marginal is diffusely diseased and in its midportion has a 50% to70% stenosis. Thereafter, the circumflex bifurcates there to give two branches, the firstof which is small in size and has a 50% stenosis in its proximal third, and the secondmarginal has a stent placed in it with severe in-stent restenosis.IMPRESSION/CONCLUSION:1. Preserved systolic function with inferior wall severe hypokinesis(decreased mobility).2. Total closure of the right coronary artery with this in-stent restenosis of avery long stent placed in the proximal right coronary artery with veryobstructive collateral filling from the conus branch to the distal right coronaryartery that appears to be small.3. Disease in the proximal left anterior descending artery.4. In-stent restenosis of the second marginal and diffuse disease in the smallmarginal.LOCATION: Outpatient, HospitalPATIENT: Glory Ann BordenSURGEON: Mohomad Almaz, MDDIAGNOSIS: Right carpal tunnel syndromePROCEDURE PERFORMED: Right carpal tunnel releaseRECOMMENDATIONS: At this point, my recommendation is to percutaneouslyrevascularize the left anterior descending artery as well as the in-stent restenosis of thecircumflex.The right coronary artery is currently totally occluded with preobstructive collateral fillingthe right coronary artery. (Restenosis of the stent is a complication of a cardiac implantNEC.)SERVICE CODE(S):ICD-10-CM DX CODE(S):INCORRECT/MISSING CODE(S):3. OPERATIVE REPORT, RIGHT CARPAL TUNNEL RELE