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Left Main Coronary In‐Stent Intimal Hyperplasia and Hemodynamics as Detected by Contrast‐Enhanced Transesophageal Echocardiography
Author(s) -
Baglini Roberto,
Amaducci Andrea,
D'Ancona Giuseppe
Publication year - 2013
Publication title -
echocardiography
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.404
H-Index - 62
eISSN - 1540-8175
pISSN - 0742-2822
DOI - 10.1111/echo.12040
Subject(s) - medicine , restenosis , cardiology , stent , basal (medicine) , diastole , hemodynamics , artery , intimal hyperplasia , angina , myocardial infarction , blood pressure , smooth muscle , insulin
Patients and methods: In‐stent hemodynamics were studied by transesophageal echocardiography ( TEE ) in a group of 54 patients after left main coronary artery stenting, during a 6‐month follow‐up. TEE was performed within 24 hours after stenting and at 1‐ and 3‐month follow‐up. Pulsed wave and color Doppler signals were enhanced by IV administration of L evovist. Results: Angiographic immediate success was obtained in all patients. No in‐hospital death occurred. Ten patients (18.4%) complained of recurrent angina at the follow‐up of 4.8 ± 1.2 months. Both TEE and coronary angiography confirmed in‐stent restenosis in all. Thirty‐nine patients (68.5%) remained symptoms free. Mean late loss in these patients was 0.69 ± 0.20 mm. A linear significant positive relation between mean late loss values and diastolic coronary velocity (r: 0.89, P < 0.001) was found. After 3‐ and 6‐month follow‐up, PDV showed a significant increase in comparison with basal values (0.7 ± 0.3 and 0.6 ± 0.26 vs. 0.32 ± 0.2 cm/sec, P < 0.01). All patients with restenosis showed a significant increase of diastolic coronary velocity in comparison with basal values (2.89 ± 0.25 cm/sec, P < 0.001). Conclusion: TEE can predict the development of in‐stent intimal hyperplasia in patients with unprotected left main coronary artery stenting.