Application of Percutaneous Coronary Sinus Occlusion in Patients with Acute Coronary Syndrome Without Hemodynamically Significant Atherosclerotic Coronary Lesions
Selective coronary angiography may reveal slightly affected coronary arteries with less than 50% of stenotic areas in 10–15% of patients with clinical and ECG picture of acute coronary syndrome.
The aim of the investigation is to evaluate the efficacy of the novel technique of endocardial and epicardial coronary bloodstream correction — intermittent percutaneous coronary sinus occlusion (PCSO) — in patients with acute coronary syndrome without hemodynamically significant atherosclerotic coronary lesions by studying the main functional parameters of the left ventricular myocardium in the medium terms (12 months later).
Materials and Methods. The results of treating 8 patients with acute coronary syndrome and ST-segment depression without hemodynamically significant coronary stenoses and initial diastolic dysfunction have been analyzed. Four patients underwent PCSO with subsequent medication, other four patients received only therapeutic treatment.
Results. In group 1 the myocardium function was observed to normalize completely in 2 individuals 12 months after the surgery (medium term). In group 2 complete normalization of diastolic myocardial function was not observed in any patient. Patients after PCSO showed statistically significantly better parameters of diastolic function 1 year after the operation compared to the results of only therapeutic treatment.
Conclusion. PCSO procedure combined with subsequent adequate therapeutic support in patients with acute coronary syndrome has significantly better effect on restoration completeness of left ventricular diastolic function compared to isolated therapeutic treatment.
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