Angiographic index of myocardial viability in patients with different duration of occlusive coronary lesion

• Published in: Vestnik hirurgii im. I.I. Grekova Vol. 181; no. 1; pp. 27 - 32
• Main Authors: Yaitskiy, N. A., Zverev, O. G., Voynov, A. V., Lazarev, S. M.
• Format: Journal Article
• Language: English; Russian
• Published: Pavlov First Saint Petersburg State Medical University 01.09.2022
• Subjects: chronic coronary occlusion; myocardial viability; recanalization of chronic coronary occlusion
• ISSN: 0042-4625; 2686-7370
• DOI: 10.24884/0042-4625-2022-181-1-27-32

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.