Complications of X-ray Endovascular Interventions in Patients with Coronary Heart Disease with Reduced Left Ventricular Systolic Function

Keywords: coronary stenting, coronary heart disease, left ventricular ejection fraction, coronary stent, myocardial infarction, interventional cardiology, X-ray, PCI, complications of percutaneous interventions

Abstract

The work is dedicated to the research of direct results and immediate possible complications of interventions in X-ray surgery with coronary stent implantation. Our patients with chronic coronary syndrome and reduced left ventricular ejection fraction (LVEF) of less than 40% were studied. The study included 112 patients who were divided into two groups. The first group included 51 patients with LVEF <40% (mean value 32.8 ± 1.14%), the second group involved 61 patients with LVEF >40% (mean value 59.4 ± 1.02%). The mean age of the subjects ranged from 59 to 74 years (mean value 63.85 ± 1.73 years).

There were no gender-related differences among the selected patients. There was no statistical difference in comorbidities in both groups. Both groups of patients were examined and managed according to the protocol of diagnosis and treatment adopted at the National Amosov Institute of Cardiovascular Surgery for patients suffering from chronic coronary syndrome.

The study results show that patients with coronary artery disease and reduced LVEF 2 times more often developed complications in early postoperative period after PCI with revascularization through stent placement than in group of patients with preserved contractile myocardial function. Duration of PCI procedure and contrast agent use was 26.3±1.4% and 29.8±4.2% higher, respectively; the frequency of life-threatening arrhythmias was 54% higher. Intraoperational signs of acute heart failure developed 4.8 times less often in the control group than in the experimental group. In general, all the patients after stenting achieved good anti-ischemic effect.

References

  1. Gandzyuk VA. [Analysis of ischemic heart disease morbidity in Ukraine]. Ukrainian Journal of Cardiology. 2014;3:45-52. Ukrainian.
  2. Kovalenko VM, Kornatskyi VM. Rehionalni medyko-sotsialni problemy khvorob systemy krovoobihu. Dynamika ta analiz [Regional medical and social problems of diseases of the circulatory system. Dynamics and analysis]. Kyiv; 2013. 239 p. Ukrainian.
  3. Kvitashvili OM. Shchorichna dopovid pro stan zdorovia naselennia, sanitarno-epidemichnu sytuatsiiu ta rezultaty diialnosti systemy okhorony zdorovia Ukrainy (2014) [Annual report on the health status of the population, the sanitary and epidemiological situation and the results of the health care system of Ukraine (2014)]. Kyiv; 2013. 460 p. Ukrainian.
  4. Patel VG, Michael TT, Mogabgab O, Fuh E, Banerjee A, Brayton KM, Cipher DJ, Abdullah SM, Brilakis ES. Clinical, angiographic, and procedural predictors of periprocedural complications during chronic total occlusion percutaneous coronary intervention. J Invasive Cardiol. 2014;26(3):100-105. PMID: 24610502.
  5. Ammirati E, Guida V, Latib A, Moroni F, Arioli F, Scotti I, Rimoldi OE, Colombo A, Camici PG. Determinants of outcome in patients with chronic ischemic left ventricular dysfunction undergone percutaneous coronary interventions. BMC Cardiovasc Disord. 2015;15:137. https://doi.org/10.1186/s12872-015-0126-x.
  6. De Silva K, Webb I, Sicard P, Lockie T, Pattinson S, Redwood S, Perera D. Does left ventricular function continue to influence mortality following contemporary percutaneous coronary intervention? Coron Artery Dis. 2012;23(3):155-161. https://doi.org/10.1097/MCA.0b013e328351162d.
  7. Sardi GL, Gaglia MA Jr, Maluenda G, Torguson R, Laynez-Carnicero A, Ben-Dor I, Hauville C, Xue Z, Suddath WO, Kent KM, Satler LF, Pichard AD, Lindsay J, Waksman R. Outcome of percutaneous coronary intervention utilizing drug-eluting stents in patients with reduced left ventricular ejection fraction. Am J Cardiol. 2012 Feb 1;109(3):344-351. https://doi.org/10.1016/j.amjcard.2011.09.016.
  8. Lin TH, Chiu CC, Chen HM, Su HM, Voon WC, Lai WT, Sheu SH, Lin YT. An Avoidable Complication of Percutaneous Coronary Intervention—Entrapment of Stent and Disconnected Balloon. Kaohsiung J Med Sci. 2006;22(4):184-188. https://doi.org/10.1016/S1607-551X(09)70305-5.
  9. Numasawa Y, Kohsaka S, Ueda I, Miyata H, Sawano M, Kawamura A, Noma S, Suzuki M, Nakagawa S, Momiyama Y, Fukuda K. Incidence and predictors of bleeding complications after percutaneous coronary intervention. J Cardiol. 2017;69(1):272-279. https://doi.org/10.1016/j.jjcc.2016.05.003.
  10. Doll JA, Hira RS, Kearney KE, Kandzari DE, Riley RF, Marso SP, Grantham JA, Thompson CA, McCabe JM, Karmpaliotis D, Kirtane AJ, Lombardi W. Management of Percutaneous Coronary Intervention Complications: Algorithms From the 2018 and 2019 Seattle Percutaneous Coronary Intervention Complications Conference. Circ Cardiovasc Interv. 2020;13(6):e008962. https://doi.org/10.1161/CIRCINTERVENTIONS.120.008962.
Published
2021-09-21
How to Cite
Aksenov, Y. V., & Demchenko, R. B. (2021). Complications of X-ray Endovascular Interventions in Patients with Coronary Heart Disease with Reduced Left Ventricular Systolic Function. Ukrainian Journal of Cardiovascular Surgery, (3 (44), 10-14. https://doi.org/10.30702/ujcvs/21.4409/a.d.040-10-14