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Cathet Cardiovasc Diagn ; 28(3): 206-13, 1993 Mar.
Article in English | MEDLINE | ID: mdl-8439995

ABSTRACT

Synchronized coronary venous retroperfusion of autologous arterial blood was offered to patients referred for medically refractory unstable angina or evolving myocardial infarction with contraindications to thrombolytic therapy. Primary endpoints of angina, ST segment deviation, and two-dimensional echocardiographic systolic wall motion were followed to determine the efficacy of retroperfusion in patients prior to and then during angioplasty, surgical intervention, or pharmacological management, as the clinical picture warranted. Over a 12 month period, 21 patients were referred and 15 received retroperfusion. All experienced full relief of angina (p = 0.008). ST segment deviations and systolic wall motion of ischemic zones were observed to improve (p = 0.06 ST changes; p = 0.0001 wall motion changes) with synchronized retrograde perfusion. During attempts to remove patients from retroperfusion, statistically significant (p < 0.01) reproducible changes in these same endpoints were documented. Retroperfusion appears to improve acute myocardial ischemia. This technique functions well in the intensive care unit environment with only fluoroscopy as technical imaging support.


Subject(s)
Angina, Unstable/therapy , Cardiac Catheterization , Coronary Vessels , Myocardial Infarction/therapy , Myocardial Reperfusion/methods , Aged , Aged, 80 and over , Angina, Unstable/diagnosis , Echocardiography , Electrocardiography , Female , Fluoroscopy , Humans , Male , Middle Aged , Myocardial Contraction/physiology , Myocardial Infarction/diagnosis
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