EARLY RECOVERY OF WALL-MOTION ABNORMALITIES AFTER RECANALIZATION OF CHRONIC TOTALLY OCCLUDED CORONARY-ARTERIES - A DOBUTAMINE ECHOCARDIOGRAPHIC, PROSPECTIVE, SINGLE-CENTER EXPERIENCE

Background Patients with symptomatic myocardial ischemia from a chroni c totally occluded coronary (TOC) artery ore usually referred for coro nary artery bypass surgery Because guide wire technology has improved considerably in recent years, percutaneous coronary angioplasty has be come a useful technique in opening chronic TOC arteries. We evaluated the early functional results of successful percutaneous recanalization by performing dobutamine stress echocardiography (DSE). Methods Fifte en patients with a chronic TOC artery who underwent a successful recan alization were prospectively studied. Each patient had a DSE within 24 hours before and 48 hours after the procedure. Wall motion was scored accord ing to a 16-segment/5-point model. A clinical and angiographic follow-up of 6 months was obtained. Results The wall motion score ind ex at rest improved From 1.26 +/- 0.23 before to 1.22 +/- 0.21 after t he procedure (P < .05). Of those 10 segments that improved at rest, 7 were collateral recipients and 3 were collateral donors. The number of ischemic segments decreased from 46 before to 4 after the procedure ( P < .0001). Wall motion score index at peak stress improved From 1.34 +/- 0.20 before to 1.15 +/- 0.12 after the procedure (P < .05). DSE wa s positive for ischemia in 15 patients before and 2 patients after the procedure (P < .0001). Angina was present in 12 patients before and i n 2 patients after recanalization (P < .0001). Two patients (13%) had angiographic reocclusion and 5 (33%) restenosis after 6 months of foll ow-up. Conclusions successful percutaneous recanalization of chronic T OC artery results in an early improvement of both clinical status and resting or stress-induced wall motion abnormalities, as detected by DS E.