-Recanalization of chronic coronary artery occlusions: effect on clinical symptoms and left ventricular function-.
Angioplasty of chronically occluded coronary arteries is discussed controversially. This study was performed to investigate the potential benefit of recanalization procedures. Between 1/91 and 10/93 occlusion angioplasty was attempted in 408 patients. 322 persons were followed with repeat angiography performed in 177 patients. Quantitative analysis of left ventricular function was performed in 34 patients before and after successful occlusion angioplasty. Primary reopening rate was about 71% with highest success rate for occluded LAD (82%). Angiographic controls showed open arteries in 80 (45.2%) patients, 53 (30.0%) had restenosis and 44 (24.8%) reocclusion. Anginal status was improved by one CCS-class or more in 197 patients (61%), mean exercise workload increased from 115.8 watts to 136.1 watts (p < 0.0001). Out of 34 patients, 25 (73.5%) showed improvement of regional ventricular function, mean ejection fraction increased from 56.9% to 64.1% (p < 0.001). Follow-up angiography revealed open arteries in 58% of patients if dissection was absent. When dissection type B, C or D NHLBI was present, only 32% of the vessels were open.


CONCLUSIONS
In selected patients occlusion angioplasty is feasible with acceptable primary results. Anginal complaints and functional status were influenced positively, left ventricular function showed improvement indicating the presence of hibernating myocardium. In patients with suboptimal primary results (dissection) repeat angiography may be indicated.
Heyder
M
M
Zentralkrankenhaus Links der Weser, Bremen.
Engel
H J
HJ
Hörmann
E
E
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000209:etiology / Q000503:physiopathology; D000787:Angina Pectoris / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D003323:Coronary Aneurysm / Q000209:etiology / Q000503:physiopathology; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000503:physiopathology / Q000628:therapy*; D005240:Feasibility Studies; D005260:Female; D006439:Hemodynamics / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction / Q000502:physiology; D012008:Recurrence; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*
Rekanalisation chronischer Koronararterienverschlüsse: Einfluss auf klinisches Beschwerdebild und linksventrikuläre Funktion.