Percutaneous coronary interventions in patients with last remaining vessel disease

ABSTRACT

High-risk patients especially those with severe left ventricular dysfunction and having last single remaining vessel [SRV] for percutaneous coronary intervention [PCI] were excluded from all randomized trials. To evaluate the feasibility of PCI and long-term follow-up of these patients with last SRV. Between October 2000 and September 2005, 42 patients who consecutively underwent PCI in our center and fulfilled the criteria of SRV were followed-up for 2 years. The in-hospital outcome was excellent without any Major Adverse Cardiac Events [MACE]. At 30-day, 4.8% died suddenly and 2.4% had non-fatal non-Q wave Myocardial Infarction [MI] leaving us with 7.1% total MACE. The long term follow-up showed excellent results with a total MACE of 25% Cardiac death of 8.3%, non cardiac [5.5%], and Target vessel Revasculariation [TVR] was 11.1%. At 2 years, those who died showed significantly more depressed systolic function, they were all diabetics [DM] and needed more than one stent than those who survived. Ejection fraction [EF] was 24.5 +/- 5.1 vs 35.2 +/- 7.9, P=0.006, DM, 100% vs 64.5%, P=0.109, and 100%vs 19.4%, P=0.0002 consecutively. The data show that PCI in last SRV is feasible, safe with an acceptable 30-days and 2 years mortality rate