Open AccessEndovascular myocardial revascularization in patients with multivessel coronary artery disease with chronic total occlusion and high surgical risk
Author(s) -
Д. К. Васильев,
Б. А. Руденко,
А. С. Шаноян,
Ф. Б. Шукуров,
Д. А. Фещенко
Publication year - 2020
Publication title -
kardiovaskulârnaâ terapiâ i profilaktika
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.158
H-Index - 16
eISSN - 2619-0125
pISSN - 1728-8800
DOI - 10.15829/1728-8800-2020-2697
Subject(s) - medicine , revascularization , cardiology , coronary artery disease , clinical endpoint , myocardial infarction , surgery , acute coronary syndrome , incidence (geometry) , randomized controlled trial , physics , optics
The main reason for incomplete myocardial revascularization is the presence of chronic coronary total occlusion (CTO), which is detected in every fourth patient during coronary angiography. At the same time, a generally accepted approach to the treatment of CTO has not yet been developed. Aim. To assess the rationale of complete myocardial revascularization in patients with multivessel coronary artery disease (CAD) with chronic total occlusion and high surgical risk. M aterial and methods. This retrospective, open-label, non-randomized clinical trial was carried out included 180 patients multivessel CAD and CTO. The patients underwent endovascular surgery for complete myocardial revascularization. Depending on the success of surgery, the patients were divided into groups of complete and incomplete myocardial revascularization. Endpoints were death, acute coronary syndrome, re-revascularization after 1-year follow-up. Left ventricular (LV) contractility and clinical status of patients in the study groups after 1 year of observation was assessed. R e sult s . The median follow-up was 12,1 months. The successful rate of revascularization was 79,4%. The incidence of main composite endpoint in the group of complete myocardial revascularization was 5,59%, while in the group of incomplete revascularizations — 21,6% (p=0,005). Conclusion . The study showed that low incidence of intraoperative complications and a high successful rate of revascularization are characteristic of complete myocardial revascularization in patients at high surgical risk with multivessel CAD and CTO. Complete myocardial revascularization leads to a significant decrease in the incidence of major coronary events.