Document Detail


Physiological impact of CTO recanalization assessed by coronary pressure measurement-A case report.
MedLine Citation:
PMID:  23359324     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
In this case report, physiological changes of myocardial perfusion in the collateral recipient right coronary artery (RCA) and the collateral donor left anterior descending artery (LAD) with an intermediate lesion were assessed using intracoronary pressure measurement, before and after revascularization of chronic total occlusion (CTO). A 44 year old male was referred for a catheter examination due to silent myocardial ischemia. An invasive coronary angiogram revealed diffuse narrowing of the RCA with focal occlusive segments in addition to intermediate stenosis in the LAD. A well developed collateral channel from the LAD to the RCA was also confirmed. Fractional flow reserve (FFRmyo) of the LAD before opening the RCA was 0.81. After successful revascularization of the RCA, FFRmyo of the LAD and the RCA were measured with and without an RCA balloon occlusion. Because collateral fractional flow reserve (FFRcoll) of the RCA could be regarded as FFRmyo before revascularization, FFRmyo of the RCA increased from 0.67 to 0.90, meaning a 23% increase of maximum flow by intervention. Interestingly, improvement of FFRmyo of the LAD from 0.81 to 0.93 was also observed, which means a 12% increase of maximum flow. Coronary steal in the LAD was reconfirmed by dramatic worsening of FFRmyo from 0.93 to 0.77 by an RCA balloon occlusion. This phenomenon may be explained by an immediate recruitment of collateral channels. This case clearly demonstrated CTO opening improves perfusion in not only myocardium supplied by the CTO vessel, but also in that which is supplied by a contra-lateral collateral donor artery. © 2013 Wiley Periodicals, Inc.
Authors:
Hitoshi Matsuo; Yoshiaki Kawase
Related Documents :
836084 - Collagen breakdown and nitrogen dioxide inhalation.
23667064 - One-stage repair of aberrant left brachiocephalic artery and coarctation of the aorta i...
25088164 - A case of bilateral giant internal carotid artery aneurysms at the cavernous portion ma...
23524504 - Tasuki clipping combined with high flow bypass for ruptured, previously coiled, partial...
22777484 - Celiac injury due to arcuate ligament: an endovascular approach.
6507494 - Familial recurrence of geleophysic dysplasia.
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-29
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  -     ISSN:  1522-726X     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-29     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2013 Wiley Periodicals, Inc.
Affiliation:
The Department of Cardiovascular Medicine, Gifu Heart Center, Gifu, Japan. matsuo@heart-center.or.jp.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Norovirus infection in children admitted to hospital for acute gastroenteritis in Belém, Pará, Nor...
Next Document:  A Novel Interaction between hScrib and PP1? Downregulates ERK Signaling and Suppresses Oncogene-Indu...