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Chronic Total Occlusion Interventions in Patients with Reduced Ejection Fraction.
Prasanna Sengodan1, Rhian E Davies2, Shunsuke Matsuno3
1West Virginia University, Morgantown, WV, USA.
Current Cardiology Reports
|December 28, 2022
Summary
Percutaneous coronary intervention for chronic total occlusions (CTO PCI) improves angina and quality of life in patients with low ejection fraction (EF). Success in this high-risk group may also improve EF, but more research is needed.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- Patients with low ejection fraction (EF) represent a high-risk group for percutaneous coronary intervention (PCI) for chronic total occlusions (CTOs).
- Optimal medical therapy (OMT) is the standard of care, but CTO PCI may offer additional benefits.
Purpose of the Study:
- To review current evidence on CTO PCI in patients with low EF.
- To provide practical guidance for performing CTO PCI in this population.
- To highlight potential benefits and limitations of CTO PCI in low EF patients.
Main Methods:
- Review of existing literature and prospective randomized controlled studies.
- Analysis of patient outcomes, including angina frequency, quality of life, and EF.
- Presentation of case examples and clinical tips.
Main Results:
- CTO PCI demonstrated greater improvement in angina frequency and quality of life compared to OMT.
- Successful CTO PCI led to similar improvements in health status for both low and normal EF patients.
- CTO PCI may ameliorate angina symptoms and potentially improve EF in carefully selected low EF patients.
Conclusions:
- CTO PCI is a viable option for selected patients with low EF and CTOs, offering symptomatic relief and potential functional improvement.
- Further large-scale studies are necessary to fully elucidate the benefits and risks of CTO PCI in patients with severely reduced EF.
Keywords:
Chronic total occlusionIschemic cardiomyopathyPercutaneous coronary interventionQuality of lifeReduced ejection fractionViability testingMore Related Videos
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