[Coronary stents in patients with severe left ventricular dysfunction. Hospital and long-term results].

Arch Mal Coeur Vaiss

Service de cardiologie, CHU Nancy-Brabois, Vandoeuvre-lès-Nancy.

Published: March 2000

The aim of this study was to evaluate the risks and benefits, immediate and at long term, of coronary angioplasty associated with stent implantation in patients with severe left ventricular dysfunction. It was a retrospective study in which all patients with left ventricular ejection fractions 35% who underwent angioplasty between December 1994 and January 1998 were included. Seventy eight patients with an average ejection fraction of 29 +/- 6% who were haemodynamically stable were retained, excluding acute myocardial infarctions and cases of cardiogenic shock. The population was mainly masculine (6(men and 13 women) with a mean age of 65 +/- 11 years. The primary success rate was 97%. The loss of a collateral branch during the procedure, causing a non-Q wave infarction and the impossibility of implanting the stent at the desired site in another patient, were the only two failures. Hospital mortality was nil. The mean follow-up period was 450 +/- 290 days; long-term mortality was 17%. All deaths were of cardiovascular origin. The probability of survival at 6 months, 1 year and 800 days, was 88, 85 and 75% respectively. The good initial results were not maintained at long-term, but this could not be attributed to restenosis or to the pre-existing left ventricular dysfunction.

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