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Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty.

Publication ,  Journal Article
Incorvati, RL; Tauberg, SG; Pecora, MJ; Macherey, RS; Krucoff, MW; Dianzumba, SB; Donohue, BC
Published in: J Am Coll Cardiol
July 1993

OBJECTIVES: This study was designed to determine the efficacy of synchronized coronary sinus retroperfusion of arterial blood in reducing myocardial ischemia associated with the performance of high risk coronary angioplasty. BACKGROUND: Previous animal and clinical work has demonstrated the efficacy of this technique in supporting ischemic myocardium. METHODS: Twenty-one patients were randomized to alternately receive coronary sinus retroperfusion support during either the second or the third coronary angioplasty balloon inflation, after an initial unsupported brief control inflation. Myocardial ischemia was assessed by the extent of echocardiographic left ventricular wall motion abnormality, quantified ST segment deviation and hemodynamic and anginal variables during balloon inflations performed with and without coronary sinus retroperfusion support. Regional wall motion score was defined as hyperkinesia (-1), normokinesia (0), hypokinesia (+1), akinesia (+2) and dyskinesia (+3). RESULTS: A reduction in the echocardiographic left anterior descending regional wall motion score in retroperfusion-supported (1.7 +/- 2.1) versus unsupported (2.7 +/- 1.6) inflations (p < 0.05) was noted. Twelve-lead electrocardiographic monitoring revealed no additional ST segment deviation during supported (173 +/- 95 s) compared with unsupported (129 +/- 87 s) angioplasty inflations despite a significantly longer duration of supported inflations (p < 0.004). Mean and peak systolic coronary sinus pressures differed during supported inflations (21 +/- 6 and 44 +/- 13 mm Hg) versus unsupported inflations (10 +/- 4 and 16 +/- 5 mm Hg) (p < 0.001). There was no difference in hemodynamic or anginal variables. CONCLUSIONS: A reduction in ischemia as defined by wall motion abnormality during retroperfusion-supported compared with unsupported angioplasty balloon inflations was documented. No additional ST segment deviation occurred during retroperfusion-supported compared with unsupported balloon inflations despite a significantly longer duration of supported inflations. No difference in hemodynamic or anginal variables was noted.

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Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

July 1993

Volume

22

Issue

1

Start / End Page

127 / 134

Location

United States

Related Subject Headings

  • Risk Factors
  • Myocardial Reperfusion
  • Myocardial Ischemia
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Hemodynamics
  • Female
  • Electrocardiography
 

Citation

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Incorvati, R. L., Tauberg, S. G., Pecora, M. J., Macherey, R. S., Krucoff, M. W., Dianzumba, S. B., & Donohue, B. C. (1993). Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty. J Am Coll Cardiol, 22(1), 127–134. https://doi.org/10.1016/0735-1097(93)90826-m
Incorvati, R. L., S. G. Tauberg, M. J. Pecora, R. S. Macherey, M. W. Krucoff, S. B. Dianzumba, and B. C. Donohue. “Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty.J Am Coll Cardiol 22, no. 1 (July 1993): 127–34. https://doi.org/10.1016/0735-1097(93)90826-m.
Incorvati RL, Tauberg SG, Pecora MJ, Macherey RS, Krucoff MW, Dianzumba SB, et al. Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1993 Jul;22(1):127–34.
Incorvati, R. L., et al. “Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty.J Am Coll Cardiol, vol. 22, no. 1, July 1993, pp. 127–34. Pubmed, doi:10.1016/0735-1097(93)90826-m.
Incorvati RL, Tauberg SG, Pecora MJ, Macherey RS, Krucoff MW, Dianzumba SB, Donohue BC. Clinical applications of coronary sinus retroperfusion during high risk percutaneous transluminal coronary angioplasty. J Am Coll Cardiol. 1993 Jul;22(1):127–134.
Journal cover image

Published In

J Am Coll Cardiol

DOI

ISSN

0735-1097

Publication Date

July 1993

Volume

22

Issue

1

Start / End Page

127 / 134

Location

United States

Related Subject Headings

  • Risk Factors
  • Myocardial Reperfusion
  • Myocardial Ischemia
  • Myocardial Contraction
  • Middle Aged
  • Male
  • Humans
  • Hemodynamics
  • Female
  • Electrocardiography