The American College of Cardiology’s 2022 meeting included live case broadcasts from the Piedmont Heart Institute at Piedmont Atlanta Hospital. This live case, performed by interventional cardiologists Dr. David Kandzari and Dr. Prashant Kaul, featured a 64-year-old patient with a complex medical history including a previous Bentall procedure with re-implanted coronary arteries. The patient presented with accelerated chest pain and dyspnea and was found to have significant ostial left main disease as well as significant in-stent restenosis of a previously placed RCA stent.