介入治疗左心室射血分数≤35%患者冠状动脉慢性完全闭塞病变的回顾性分析  

The Single-center Experience of Percutaneous Coronary Intervention of Chronic Total Occlusion Lesion inPatients With Left Ventricular Ejection Fraction ≤ 35%

作　　者：管浩[1] 崔锦钢[1] 胡奉环[1] 袁建松[1] 乔树宾[1] GUAN Hao;CUI Jingang;HU Fenghuan;YUAN Jiansong;QIAO Shubin(Coronary Heart Disease Center,National Center of Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病中心,北京市100037

出　　处：《中国循环杂志》2020年第11期1078-1083,共6页Chinese Circulation Journal

摘　　要：目的:总结单中心左心室射血分数(LVEF)≤35%患者冠状动脉慢性完全闭塞(CTO)病变经皮冠状动脉介入治疗(PCI)经验。方法:回顾中国医学科学院阜外医院冠心病中心自2010年1月至2017年12月接受CTO-PCI治疗,且术前经胸超声心动图检查LVEF≤35%患者,共纳入39例符合研究条件患者。按照CTO病变是否成功行PCI,分为成功组、失败组、部分开通组,比较三组患者临床资料,包括基线资料、冠状动脉造影结果、CTO-PCI操作相关并发症、主动脉球囊反搏应用等;以院内主要不良心脑血管病事件(MACCE)及操作相关并发症作为主要研究终点。结果:本研究共纳入39例患者,其中成功组26例,失败组6例,部分开通组7例。共计52处CTO病变,计划开通43处,旷置9处,成功开通37处(86.0%)。MACCE:失败组明显高于成功组、部分开通组(100%vs.38.5%vs.28.6%,P=0.035);操作相关并发症:部分开通组低于成功组、失败组(0%vs.23.1%vs.33.3%,P=0.028)。结论:LVEF≤35%合并CTO病变患者,选择性CTO-PCI是合理的短期治疗策略。Objectives:To summarize our singe-center experience of percutaneous coronary intervention(PCI)on chronic total occlusion(CTO)lesion in patients with left ventricular ejection fraction(LVEF)≤35%.Methods:We collected the clinic data of patients with LVEF≤35%and underwent CTO-PCI from January 2010 to December 2017 in Fuwai Hospital,and grouped the patients into succeed,failed and incomplete revascularization groups according to the CTO-PCI results.The baseline data,intervention indications,LVEF and adverse events were compared among groups.Results:A total of 39 patients were enrolled and there were 26 patients in the succeed group(S group),6 patients in failed group(F group),and 7 patients in incomplete revascularization group(IR group).CTO-PCI was planned in 43 out of 52 CTO lesions,revascularization succeeded in 37(86.0%)lesions.The major adverse cardiac and cerebral vascular events(MACCE)was significantly higher in F group than in S group and IR group(100%vs.38.5%vs.28.6%,P=0.035).Complications related to PCI was numerically lowest in IR group(0%vs.23.1%vs.33.3%,P=0.028).Conclusions:Selective CTO-PCI strategy is reasonable and feasible for CTO patients with LVEF≤35%.

关 键 词：冠状动脉慢性完全闭塞病变 冠状动脉介入治疗 左心室收缩功能减低 选择性血运重建 

分 类 号：R541.4[医药卫生—心血管疾病]