Angiographic index of myocardial viability in patients with different duration of occlusive coronary lesion
https://doi.org/10.24884/0042-4625-2022-181-1-27-32
Abstract
INTRODUCTION. Evaluation of myocardial viability in chronic coronary occlusion determines the feasibility of revascularization of this zone.
The OBJECTIVE was to evaluate the significance of the angiographic index in determining the viability of the myocardium at various times after occlusion of the coronary artery.
METHODS AND MATERIALS. 156 patients with coronary artery disease (CAD) with chronic coronary occlusion according to coronary angiography (CG) were examined and treated during the period from 2012 to 2021. All patients underwent endovascular recanalization of chronic coronary occlusion. All patients were divided into 4 groups depending on the time of coronary occlusion (up to 3 months, 3-6 months, 6-9 months, more than 9 months) The results of recanalization were compared to the preoperative evaluation of myocardial viability based on the volume of collateral blood flow (Renrop score).
RESULTS. The angiographic index of non-viable myocardium was highly specific from the first months in all observation groups (77, 94, 97, 97.5 %), however, its sensitivity had diagnostic value only in patients with occlusion duration of more than 6 months (80 % or more).
CONCLUSION. The diagnostic value (sensitivity and specificity) of detecting non-viable myocardium based on retrograde collateral blood flow is significant for occlusion duration of more than 6 months. Refusal of revascularization based on the absence of retrograde blood flow during the first 6 months after coronary occlusion is not correct.
About the Authors
N. A. Yaitskiy
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Nikolay A. Yaitskiy - Dr. of Sci. (Med.), Professor, Academician of the Russian Academy of Sciences, Head of the Department of Hospital Surgery with Clinic, Pavlov University.
Saint Petersburg.
Competing Interests:
The authors declare no conflict of interest.
O. G. Zverev
Pavlov University; Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Competing Interests:
Russian Federation
Oleg G. Zverev - Dr. of Sci. (Med.), Professor of the Department of Hospital Surgery with Clinic, Pavlov University; Head of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Saint Petersburg Research Institute of Phthisiopulmonology.
6-8, L'va Tolstogo str., Saint Petersburg, 197022.
Competing Interests:
The authors declare no conflict of interest.
A. V. Voynov
Pavlov University; Saint Petersburg Research Institute of Phthisiopulmonology
Russian Federation
Competing Interests:
Russian Federation
Alexey V. Voynov - Assistant of the Department of Hospital Surgery with Clinic, Pavlov University, Doctor of the Department of X-ray Surgical Methods of Diagnosis and Treatment, Saint Petersburg Research Institute of Phthisiopulmonology.
6-8, L'va Tolstogo str., Saint Petersburg, 197022.
Competing Interests:
The authors declare no conflict of interest.
S. M. Lazarev
Pavlov University
Russian Federation
Competing Interests:
Russian Federation
Sergey M. Lazarev - Dr. Sci. (Med), Professor, Department of Hospital Surgery with Clinic, Pavlov University.
Saint Petersburg.
Competing Interests:
The authors declare no conflict of interest.
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For citations:
Yaitskiy N.A., Zverev O.G., Voynov A.V., Lazarev S.M. Angiographic index of myocardial viability in patients with different duration of occlusive coronary lesion. Grekov's Bulletin of Surgery. 2022;181(1):27-32. (In Russ.) https://doi.org/10.24884/0042-4625-2022-181-1-27-32
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