Perfluorochemical perfusion during coronary angioplasty in unstable and high-risk patients

Perfluorochemical perfusion during coronary angioplasty was performed in 38 patients with unstable ischemic syndromes or with high-risk lesions in a single-blind crossover study. Patients received alternate 90-second balloon inflations with and without distal perfusion of oxygenated perfluorochemica...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 1990-03, Vol.81 (3 Suppl), p.IV27-IV34
Main Authors: Cowley, M J, Snow, F R, DiSciascio, G, Kelly, K, Guard, C, Nixon, J V
Format: Article
Language:English
Subjects:
Adult
Aged
Angina Pectoris - etiology
Angina Pectoris - physiopathology
Angina Pectoris - therapy
Angina, Unstable - drug therapy
Angina, Unstable - physiopathology
Angina, Unstable - therapy
Angioplasty, Balloon, Coronary - adverse effects
Blood Substitutes
Cardiac Output
Electrocardiography, Ambulatory
Female
Fluorocarbons - therapeutic use
Heart - physiopathology
Heart Ventricles
Hemodynamics
Humans
Male
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - therapy
Perfusion
Risk Factors
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Summary:Perfluorochemical perfusion during coronary angioplasty was performed in 38 patients with unstable ischemic syndromes or with high-risk lesions in a single-blind crossover study. Patients received alternate 90-second balloon inflations with and without distal perfusion of oxygenated perfluorochemical (Fluosol, Alpha Therapeutic Corp., Los Angeles, California) at 60 ml/min. Efficacy was assessed by anginal intensity, hemodynamic and electrocardiographic parameters, and left ventricular function determined by two-dimensional echocardiography during balloon inflations. There was a trend toward lower anginal intensity with Fluosol perfusion at 30, 60, and 90 seconds of occlusion. Pulmonary wedge pressure increased significantly with and without Fluosol perfusion, and the magnitude of change was not different. Cardiac output decreased significantly less with Fluosol perfusion than with routine inflation for the total group (-0.8 vs. -1.2 l/min, p less than 0.01) and in the subgroup with left anterior descending coronary artery (LAD) angioplasty (-0.7 vs. -1.5 l/min, p less than 0.001). Left ventricular ejection fraction (EF) by echocardiography declined significantly less with Fluosol perfusion (-4.0 vs. -7.9 EF units, p less than 0.004) than with routine inflation for the total population and declined significantly less with Fluosol in the subgroup with LAD angioplasty (-5.5 vs. -9.7 EF units, p less than 0.008). Regional wall-motion abnormality score increased significantly with routine inflation (from 0.7 +/- 1.4 to 3.5 +/- 3.2, p less than 0.001) and did not change with Fluosol perfusion (from 0.8 +/- 1.3 to 1.3 +/- 1.1, p = NS).
ISSN:0009-7322