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Current Cardiology Reports

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01-11-2018 | Myocardial Disease (A Abbate, Section Editor)

Role of Percutaneous Chronic Total Occlusion Interventions in Patients with Ischemic Cardiomyopathy and Reduced Left Ventricular Ejection Fraction

Authors: Nayef A. Abouzaki, Jose E. Exaire, Luis A. Guzmán

Published in: Current Cardiology Reports | Issue 11/2018

Abstract

Purpose of Review

The purpose of this review is to examine current evidence on the benefit of chronic total occlusion (CTO) revascularization in patients with ischemic cardiomyopathy and propose a systematic approach on how and when to accomplish revascularization in these patients.

Recent Findings

Coronary revascularization in patients with reduced ejection fraction (EF) is advocated for to improve left ventricular function and consequently clinical outcomes. Approximately 16–31% of angiograms in patients with advanced CAD are noted to have a concomitant coronary CTO. Its presence is a main predictor of worse outcomes. Over the past 15 years, advancements in interventional technologies and techniques have made it possible to treat CTO lesions percutaneously with success rates exceeding 90%.

Summary

Different revascularization techniques have been organized into widely used algorithms for systematic CTO lesion crossing and treatment. Patients with reduced EF can be revascularized percutaneously with goal of complete functional revascularization. However, randomized prospective data is needed to justify the increased patient risks and healthcare costs associated with these procedures.

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Title: Role of Percutaneous Chronic Total Occlusion Interventions in Patients with Ischemic Cardiomyopathy and Reduced Left Ventricular Ejection Fraction
Authors: Nayef A. Abouzaki
Jose E. Exaire
Luis A. Guzmán
Publication date: 01-11-2018
Publisher: Springer US
Published in: Current Cardiology Reports / Issue 11/2018
Print ISSN: 1523-3782
Electronic ISSN: 1534-3170
DOI: https://doi.org/10.1007/s11886-018-1066-8

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