83 year-old female with new onset crescendo CCS Class III angina and dyspnea with known moderate left main disease since 2009. A Cardiac Cath on January 12, 2015 revealed calcified distal left main bifurcation: 80% distal LM, 70% proximal LAD and 90% proximal LCx with normal systolic LV function; SYNTAX Score 24. Heart Team discussion took place and patient elected for PCI. Patient is now planned for PCI of calcified dLM bifurcation using OCT, rotational atherectomy and planned dedicated two stents approach.

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