Assessment of left ventricular ,wall motion abnormalities after rescue angioplasty of the infarct related artery

Abstract

Coronary angiopl sty has now•. become an important Interventional therapy in acute myocardial infarction. Rescue PTCA has been advocated as a mechanical method to achieve reperfusion when infarct related artery remains occluded after thrombolytic therapy. On the other hand the benefit-risk ratio of rescue angioplasty is still controversial. The aim of this study is to evaluate and study the left ventricular segmental wall motion abnormalities by transthoracic echocardiography before and after rescue PTCA. Sixteen patients in the period between December J996.and March 1998 were entered into the CCU of the cardiovascular department of Cairo University with picture of acute myocardial infarction. Thi1teen patients (81.2%} were males and three patients (18.7%) were females. The mean age was 51.37 ± II years ranging from 33 to 70 years. Nine patients presented with anterior

myocardial infarction (56.25%) and seven presented with inferior myocardial infarction (43.7%). The overall success rate was (85.7%), failure to recanalized the infarct related artery occurred in one patient (7.1%). The mortality rate was (7.1%) as one patient was in cardiogenic shock. Echocardiographic analysis showed significant improvement in the segmental wall motion abnormality score and the left ventricular ejection fraction from pre to post PTCA and this improvement was maintained during the follow up period of two months.