Coronary Intervention in Multivessel Disease: Outcome and Correlates Of Morbidity And Mortality

Abstract

The coronary interventions in patients wi th multi vessel coronary a tiery disease are frequentl y called high-risk interventions. The outcome of such high risk interventions depends on several factors including left ventricular function , loca tion of the lesion, type of the lesion , the num ber of vessels affected and the amount of a potentially ischemic m yocardium "jeopard y myoca rdium". Prospecti ve, ra nd omized clinical trial s have dem onstrated that Ill patients with multi vesse l disease with an anatomy suita ble for both PTCA and CABG, an initi a l strategy of PICA res ults in a simil a r incidence of Ml or death. However, the PICA group had a high er in ciden ce of recurrent a n g ma and great er need for repeat revascul a ri za ti on seconda ry t o hi gher restenosi s ra te ( RITA trial participants, 1993 and CABRJ trial participants, 1995 ). On the other hand, coronary slenting has been shown to be an effecti ve devi ce in t wo areas: bailout after failed PTCA and reduction of restenosis in selected

l esions. Jn add ition, improvements in deploy ment technique and phar macological therapy after stenting have increased its overall efficacy and cost effecti veness (Fischman et al., 1994 and Serruys et al., 1994). Aim o(tlle Work:- This study a tms at evaluating the results of multi vessel corona ry intervention and the predictors of its morbidity and mortality.