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European Heart Journal 1994 15(8):1057-1062;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Coronary angioplasty in high risk patients with percutaneous cardiopulmonary support

M. U. SIVANANTHAN, M. R. REES, T. F. BROWNE, S. P. VERMA, D. G. HICK, S. WHITTAKER, G. A. DAVIES and L. B. TAN

Department of Cardiac Radiology and the Cardiac Research Unit, Regional Cardiothoracic Centre, Killingbeck Hospital Leeds U.K

Received 26 February 1993; revised 24 March 1994; .

Correspondence: Dr U. M. Sivananthan, Department of Cardiac Radiology, Kilhngbeck Hospital, York Road, Leeds LS14 6UQ, U.K.

Abstract

Cardiopulmonary Support (CPS) was employed electively in 13 patients during high risk percutaneous transluminal coronary angioplasty (PTCA) in accordance with a selection criteria, which included at least two of the following; (i) left ventricular ejection fraction of less than 35%, (ii) target vessel(s) supplying more than 50% of the viable myocardium, and (iii) patients refused coronary bypass surgery. The mean age of the patients was 56.8 ± 10.7 years (range 39–77). PTCA was attempted in a total of 35 lesions in 12 patients; 29 lesions were successfully dilated (technical success rate of 82.9%). On average, 2.7 lesions were attempted in each patient, and 2.2 lesions were successfully dilated per patient. In one patient the procedure was abandoned due to dissection of the iliac artery during cannulation. One patient died of a large pulmonary embolism 72 h after the procedure. All the surviving 11 patients who had successful PTCA on CPS showed symptomatic improvement during a mean follow-up period of 18.5 ± 4.3 months (range 11 to 24 months). The commonest complication encountered following the CPS-assisted PTCA was local haematoma (nine of 13 patients), but all patients required transfusion due to significant periprocedural blood loss. Our early experience suggests that CPS enhances the safety of undertaking PTCA in high risk patients.

Key Words: Cardiopulmonary support • percutaneous transluminal coronary angioplasty


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