Affiliation:
1. Catharina Hospital Eindhoven The Netherlands
2. Essex Cardiothoracic Centre Basildon United Kingdom
3. School of Medicine Anglia Ruskin University Chelmsford United Kingdom
4. Eindhoven University of Technology Eindhoven The Netherlands
Abstract
Background
This study aimed to investigate longitudinal physiological changes in the recanalized coronary chronic total occlusion (CTO) vessel and its dependent myocardium after successful percutaneous coronary intervention (
PCI
).
Methods and Results
In this pilot study, 25 patients scheduled for elective
CTO PCI
with viable myocardium and angiographically visible collaterals were included. Absolute coronary blood flow and absolute microvascular resistance were measured invasively using continuous thermodilution. Measurements were performed immediately after successful
CTO PCI
and at short‐term follow‐up. In a subgroup of patients, physiological measurements were performed at the predominant donor vessel before
CTO PCI
, immediately afterwards, and at follow‐up. Absolute coronary blood flow in the recanalized
CTO
artery increased from 148±53
mL
/min immediately after
PCI
to 221±77
mL
/min at follow‐up (
P
<0.001). In agreement, absolute resistance in the myocardial territory perfused by the
CTO
artery, decreased from 545±255 Wood units immediately after the procedure to 387±128 Wood units at follow‐up (
P
=0.014). There were no significant changes in the absolute coronary blood flow and resistance in the predominant donor between baseline and follow‐up. Positive remodeling of the distal
CTO
vessel with an increase in lumen diameter was observed.
Conclusions
After successful
CTO PCI
, blood flow in the recanalized artery and microvascular function of the dependent myocardium are not immediately normal but recover over time.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Cardiology and Cardiovascular Medicine
Cited by
12 articles.
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