Novel Technique of Endovascular Retrograde Circulatory Support in Patients with Acute Coronary Syndrome: Emphasis on Myocardium Functional State

The aim of the investigation is to evaluate the efficacy of the novel technique of endovascular retrograde circulatory support of the cardiac muscle according to the data obtained by studying the main functional parameters of the left ventricular myocardium in the medium terms after complete high-risk radioendovascular revascularization carried out in patients with acute coronary syndrome (ACS) with ST-elevation and non-ST-elevation and multivessel lesion of the coronary arterial bloodstream.

Materials and Methods. The results of treating 24 patients with ACS and initial myocardial dysfunction have been analyzed. Group 1 (n=12) included ACS patients with ST-elevation, patients of group 2 (n=12) were with non-ST-elevation. Both groups were divided into equal subgroups: subgroup A comprised patients with retrograde perfusion circulatory support; whereas subgroup B included patients without retrograde perfusion support.

Results. In group 1 complete myocardium function was observed to normalize in 7 individuals (in 6 and 1 patients in subgroups A and B, respectively) 12 months after the operation (medium term). In group 2 complete normalization of the myocardium function occurred in 6 individuals (in 4 and 2 patients in subgroups A and B, respectively) in the same period. Patients in subgroups A had significantly better parameters of local contractility and diastolic function 12 months after the operation compared to the patients from subgroups B.

Conclusion. Application of the novel technique of retrograde perfusion of the left ventricular anterior wall during complete endovascular revascularization in high-risk patients with ACS results in essential improvement of the results.

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