PCI in the Management of Patients with Impaired Left ...
PCI IN THE MANAGEMENT OF PATIENTS WITH IMPAIRED LEFT VENTRICULAR FUNCTION
G.W. Vetrovec
Virginia Commonwealth University, Richmond, VA, USA
Remote studies suggest that revascularization, specifically with bypass surgery is associated with improved outcomes for patients with severe LV dysfunction. Such data includes the LV dysfunction sub study from CASS and data from a retrospective analysis of the SOLVD trial which in both studies show an improved survival for high risk patients with impaired LV function undergoing bypass surgery.
Early balloon PCI data showed that acute survival in patients was common, but there appeared to be a high risk of subacute deaths within 9 months of the procedure. Complicating this data is the fact that patients were often surgical “turndowns”.
Developing current outcomes for PCI in LV dysfunction is difficult because major trials have low rates of LV dysfunction represented. In SYNTAX only 2.5% of patients had measured LV compromise. However, clinical data suggests frequent LV impairment. In the NY Database, 63% of patients undergoing PCI had an LVEF of 10% having LVEF ................
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