[Coronary angioplasty in patients with compromised left ventricular function].
One thousand one hundred and thirty-two percutaneous transluminal coronary angioplasties have been performed at Centro Cuore Columbus in Milan between January 1987 and September 1989. The whole population was divided into two groups: Group A (90 patients with ejection fraction less than or equal to 0.40); Group B (678 patients with ejection fraction greater than 0.40. Mean ejection fraction in Group A (0.35) was significantly lower (p less than 0.0001) than in Group B (0.56). In each group three subsets were identified: subgroup 1: total obstruction of two major epicardial vessels plus severe stenosis of the patent one; subgroup 2: total obstruction of one vessel plus severe stenosis on a different remote one; subgroup 3: all patent vessels with one or more severe stenoses on one or all. We attempted percutaneous transluminal coronary angioplasties on 923 stenosed and 161 totally obstructed vessels, with a primary success of 95 and 56% respectively. We experienced 36 major complications (7 deaths, 10 acute myocardial infarctions, 19 emergency aortocoronary bypasses in 21 patients (2.7% of the whole population). Subgroup A1 (7 patients with ejection fraction less than or equal to 0.40 and attempted percutaneous transluminal coronary angioplasties on the sole patent vessel) showed the lowest success rate (44%) and the highest complication rate: 3 deaths (42.8%); 1 acute myocardial infarction (14.2%); 3 emergency aorto-coronary by-pass (42.8%). The 83 patients in group A2 and A3, with reduced ejection fraction, did not have significantly higher complication rate than all group B patients, with normal ejection fraction.(ABSTRACT TRUNCATED AT 250 WORDS)
Colombo
A
A
Centro Cuore Columbus, Sezione Emodinamica, Milano.
Lisanti
P
P
Serino
W
W
Mutinelli
M R
MR
Torielli
A
A
Gianrossi
R
R
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000503:physiopathology / Q000628:therapy*; D003251:Constriction, Pathologic / Q000503:physiopathology / Q000628:therapy; D003327:Coronary Disease / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D016277:Ventricular Function, Left
Angioplastica coronarica in pazienti con funzione ventricolare sinistra compromessa.