Coronary angioplasty in potential recipients of donors hearts

DOI: https://doi.org/10.25512/DIR.2007.01.3.09

For quoting:
Mironkov A.V., Pokatilov A.A., Ryadovoy I.G., Ostroumov E.N., Chestukhin V.V. "Coronary angioplasty in potential recipients of donors hearts". Journal Diagnostic & interventional radiology. 2007; 1(3); 66-74.

authors:

Mironkov A.V.

Pokatilov A.A.

Ryadovoy I.G.

Ostroumov E.N.

Chestukhin V.V.

keywords:

ischemic cardiomyopathy

percutaneous coronary interventions

ECG-gated SPECT

Abstract:

The aim of the study was to evaluate results of percutaneous coronary interventions (PCI) in patients with ischemic cardiomyopathy (ICMP) - potential candidates for heart transplantation. The study included 37 patients with ICMP. All the patients before PCI and within the 7 days after it undergo ec-hocardiography and ECG-gated SPECT. The amount of irreversibly damaged myocardium of the left ventricle (LV) was about 50 % of its volume. In these patients ECG-gated SPECT did not show sufficient amount of the viable myocardium, capable to restore the heart function after revascularization. The main result of intervention was increase in survival rate of patients with ICMP within 4 years of observation in comparison with traditional methods of conservative therapy. The first clinical effect of PCI was disappearance or reduction of dyspnea, noted in the majority of the patients. These changes had been confirmed by improvement of a functional class of patients (NYHA class score increase to 3,2±0,5 from 1,7+65; p=0,007) and increase of tolerance to physical excersise. Positive changes of a clinical condition after PCI have taken place due to decrease in rigidity of LV myocardium: It became apparent due to decrease of LV end-diastolic pressure (35,7+9,3 vs. 23,5+9,9 Hg mm; p=0,04) and pressure in pulmonary artery (44+1 2 vs. 33+7 Hg mm; p=0,03). No changes of LV volumes and ejection fraction values in the given category of patients were seen.

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