[Reopening of chronic coronary occlusions--initial references for prognostic indications].
Today indication for percutaneous transluminal coronary angioplasty is based on typical chest pain and objective signs of myocardial ischemia during exercise. Especially in chronic coronary occlusions, however, prognostic implications may play an increasing role in the future. The case report describes long-term follow-up of a patient in whom a chronic complete occlusion of the right coronary artery could be reopened successfully back in September 1988. At this time, the peripheral part of the occluded RCA was filled retrogradely by septal collaterals from the LAD. After reopening the patient remained symptom-free for more than two years. In January 1991 again severe angina recurred and ECG showed a non-transmural anterior myocardial infarction. The LAD was occluded proximal and the peripheral part was filled retrogradely by septal collaterals coming from the right coronary artery which was still open (flow reversal). Left ventricular function was only slightly impaired and the LAD occlusion could be reopened successfully too. The case suggests that prognostic implications should be taken into consideration in addition to symptoms especially in complete coronary occlusions.
Vallbracht
C
C
Herz- und Kreislaufzentrum Rotenburg a.d. Fulda.
Stock
M
M
Oster
H
H
Unverdorben
M
M
Kober
G
G
Kaltenbach
M
M
D000368:Aged; D017225:Atherectomy, Coronary; D003097:Collateral Circulation / Q000502:physiology; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000601:surgery*; D012008:Recurrence; D012086:Reoperation; D016277:Ventricular Function, Left
Wiedereröffnung chronischer Koronarverschlüsse--erste Hinweise auf eine prognostische Indikation.