Clinical effectiveness of bilateral recanalization of chronic coronary artery occlusion
| Autor: | M. S. Zhuravel, A. O. Oleynik, A. K. Sanbaev, I. S. Ruzanov, I. V. Titkov, E. A. Glukhov, I. V. Shitikov |
|---|---|
| Jazyk: | ruština |
| Rok vydání: | 2012 |
| Předmět: |
medicine.medical_specialty
Ejection fraction Percutaneous medicine.diagnostic_test business.industry medicine.medical_treatment coronary angioplasty medicine.disease recanalization Cardiac surgery Angina chronic coronary artery occlusion medicine.anatomical_structure Internal medicine Angioplasty RC666-701 Angiography bilateral recanalization medicine Cardiology Diseases of the circulatory (Cardiovascular) system Cardiology and Cardiovascular Medicine business Electrocardiography Artery |
| Zdroj: | Кардиоваскулярная терапия и профилактика, Vol 11, Iss 6, Pp 33-37 (2012) |
| ISSN: | 2619-0125 1728-8800 |
| Popis: | Aim. To assess the short- and long-term angiographic and clinical effectiveness of endovascular bilateral recanalization of chronic coronary artery occlusion (CCAO), compared to conservative therapeutic strategy. Material and methods. The study included 56 patients with coronary heart disease and CCAO. Angina Functional Class (FC) was assessed clinically and in electrocardiography tests. Local and global myocardial contractility was assessed using echocardiography. Group I (n=36) included CCAO patients who underwent an attempt of bilateral percutaneous coronary angioplasty; Group II (n=20) included CCAO patients who were treated conservatively. Clinical effectiveness of the treatment was assessed at 12 months. Results. At baseline, 16 and 20 Group I patients had FC III and II, respectively. Out of 36 attempts of bilateral recanalization, 27 were successful, based on the angiography results. All these 27 cases were also clinically successful in the short term, and 20 in the long term. Global myocardial contractility increased from 54±3% to 56,9±4% (p=0,03). In Group II, 10 and 10 patients had baseline FC III and II, respectively. The long-term stabilisation of clinical status was observed in 15 patients, with the mean levels of left ventricular ejection fraction of 53,9±2,4% (p=0,9). Observed complications of coronary angioplasty did not result in clinically significant ischemic and haemorrhagic events, while the clinical improvement was substantially more pronounced, compared to Group II. Conclusion. Bilateral CCAO recanalization is a technically demanding procedure, requiring an extensive surgical expertise and experience, and linked to a higher risk of complications. However, it could be used when the antegrade access is impossible; the anaesthesiological risk of coronary artery bypass graft surgery is high; and the patient refuses the cardiac surgery intervention. |
| Databáze: | OpenAIRE |
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