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Updated: Aug 26, 2026
Myocardial Infarction and Functional Outcome Assessment in Pigs
Published on: April 25, 2014
Immediate and late results of coronary angioplasty in patients with severe left ventricular dysfunction
Federica Marsico1, Emanuela Morenghi, Dennis Zavalloni Parenti
1Invasive Cardiology Department, Istituto Clinico Humanitas, Rozzano, MI, Italy. fmarsico@hotmail.com
Insights
Percutaneous transluminal coronary angioplasty (PTCA) shows high success in treating coronary artery disease with severe left ventricular dysfunction. However, long-term outcomes are not significantly improved by PTCA.
Area of Science:
- Cardiology
- Interventional Cardiology
- Cardiac Surgery
Background:
- Severe coronary artery disease (CAD) with depressed left ventricular (LV) function indicates a poor prognosis.
- Percutaneous transluminal coronary angioplasty (PTCA) is an alternative to bypass surgery, but its role in patients with severe LV dysfunction is unclear.
Purpose of the Study:
- To evaluate the immediate and long-term results of PTCA in patients with severe LV dysfunction (ejection fraction ≤35%).
Main Methods:
- Analysis of 125 patients with LV ejection fraction ≤35% who underwent PTCA.
- Assessment of procedural success, complications, and long-term outcomes including restenosis and mortality.
Main Results:
- Angiographic success was achieved in 96% of patients, with major complications in 4% and a 1.6% mortality rate.
- Long-term follow-up revealed re-PTCA in 34% due to restenosis and a 10.4% mortality rate.
- An occluded left anterior descending artery not treated by PTCA or bypass graft was the only predictor of death.
Conclusions:
- PTCA is effective for CAD in patients with severe LV dysfunction, offering high procedural success and low immediate complications.
- Long-term follow-up suggests PTCA does not significantly influence overall survival in this patient group.
Background:
Severe coronary artery disease in patients with a markedly depressed left ventricular function is associated with a poor prognosis. Even though coronary angioplasty (PTCA) has been offered as an alternative to bypass surgery, the role of PTCA in the treatment of patients with severe left ventricular dysfunction has not been well defined. The aim of the present study was to evaluate the immediate and long-term results in patients with severe left ventricular dysfunction < or = 35% who underwent PTCA.
Methods:
One hundred and twenty-five patients with a left ventricular ejection fraction < or = 35% who underwent PTCA were analyzed.
Results:
The mean left ventricular ejection fraction was 29.7%. Eighty-seven patients (69.6%) had multivessel disease and 41 (32.8%) had previous coronary artery bypass graft. Intra-aortic balloon pumping was used in 12% of cases. Angiographic success was achieved in 96% of patients. Complete revascularization was achieved in 56 patients (44.8%). Major complications occurred in 4% of the population and 2 patients died (1.6%). During the long-term follow-up re-PTCA due to angiographic restenosis was performed in 41 patients (34%); 12 patients (10.4%) died. The only parameter which significantly correlated with death was the presence of an occluded left anterior descending coronary artery not recanalized neither with PTCA nor with coronary artery bypass graft.
Conclusions:
These data suggest that PTCA may be an effective treatment for coronary artery disease in patients with left ventricular dysfunction and is associated with high procedural success rate and low complications; however, the long-term follow-up seems not to be influenced by the PTCA procedure.
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