High-risk coronary angioplasty assisted by active hemoperfusion. A feasibility study.
We assessed the effectiveness of distal hemoperfusion support during gradual, prolonged balloon inflation during percutaneous transluminal coronary angioplasty in high-risk patients. The patients were identified as having a poor left ventricular ejection fraction ( < 35%), > 50% of viable myocardium at risk percutaneous coronary balloon angioplasty, or both. A total of 64 procedures were performed in 61 patients. Angiographic success was achieved in 83 of 86 (96.5%) lesions treated with hemoperfusion support. Hospital complications included 1 patient who had a non-Q-wave infarction, 1 who had to undergo redo percutaneous coronary balloon angioplasty, and 5 who required coronary artery bypass operations. The hospital mortality was 7.8% (5 patients). This preliminary study indicates that hemoperfusion support can enable expeditious, simple, economical, and effective percutaneous transluminal coronary balloon angioplasty in a subset of labile patients in whom procedural failure frequently leads to sudden death.
Angelini
P
P
Department of Adult Cardiology, St. Luke's Episcopal Hospital, Houston, Texas, USA.
Hernandez
C
C
Ferguson
J J
JJ
Leachman
R D
RD
Garcia-Gregory
J A
JA
Benrey
J
J
Schnee
M J
MJ
Fighali
S F
SF
Krajcer
Z
Z
D015906:Angioplasty, Balloon, Coronary / Q000191:economics / Q000295:instrumentation / Q000379:methods*; D016022:Case-Control Studies; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D003365:Costs and Cost Analysis; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D006353:Heart-Assist Devices; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D013318:Stroke Volume / Q000502:physiology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology