The Efficacy of Retrograde Myocardial Perfusion in Endovascular Correction of Severe Anterior Coronary Circulation Disorders in Patients with Non-ST-Elevation Acute Coronary Syndrome

Patients with non-ST-elevation acute coronary syndrome (non-ST-elevation ACS) require emergency percutaneous coronary intervention in case of high risk of death or myocardial infarction development at hospital stage.

The aim of the investigation was to assess the efficacy of a new technique of retrograde perfusion support of coronary blood flow in the process of endovascular correction of severe anterior coronary circulation disorders in high-risk patients with non-ST-elevation ACS.

Materials and Methods. We studied the treatment results of 12 patients after X-ray endovascular intervention. Group 1 involved 6 patients with performed retrograde perfusion support of coronary circulation, group 2 — 6 patients without retroperfusion support.

Results. In group 1 we observed the significant decrease of ST depression in V₁–V₃ leads at the 60^th second of antegrade blood flow deficiency in anterior coronary blood flow in the course of retroperfusion compared to angioplasty without coronary circulation support (with retroperfusion — –0.4±0.1 mm; without retroperfusion — –1.5±0.8 mm; p=0.027). In group 2 without retrograde perfusion support, in all patients at the 60^th second of antegrade blood flow deficiency there was the significant ST depression increase in the same leads (–2.4±0.9 mm; p=0.027) compared to basic ECG-picture. The similar dynamics was observed in relation to arterial pressure indices.

Conclusion. Selective retroperfusion of the great cardiac vein can be used as an effective technique of intra-operative support of cardiohemodynamics in high-risk patients with non-ST-elevation ACS.

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Shakhov Е.B., Petrov D.V., Volkov D.V., Novikov А.S., Kosonogov К.А., Timoschenko Е.S., Petrova Е.B., Shakhov B.Е. The Efficacy of Retrograde Myocardial Perfusion in Endovascular Correction of Severe Anterior Coronary Circulation Disorders in Patients with Non-ST-Elevation Acute Coronary Syndrome. Sovremennye tehnologii v medicine 2014; 6(4): 68