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Review
. 2023 Feb;25(2):43-50.
doi: 10.1007/s11886-022-01832-z. Epub 2022 Dec 28.

Chronic Total Occlusion Interventions in Patients with Reduced Ejection Fraction

Prasanna Sengodan  1 , Rhian E Davies  2 , Shunsuke Matsuno  3 , Albert K Chan  4 , Kathleen Kearney  5 , Adam Salisbury  6 , J Aaron Grantham  6 , Taishi Hirai  7
Affiliations
Review

Chronic Total Occlusion Interventions in Patients with Reduced Ejection Fraction

Prasanna Sengodan et al. Curr Cardiol Rep. 2023 Feb.

Abstract

Purpose of the review: The goal of this paper is to review the current evidence surrounding CTO PCI in patients with low EF, the most high-risk population to treat. We also present pertinent case examples and offer practical tips to increase success and lower complications when performing CTO PCI in patients with low EF.

Recent findings: In a prospective randomized control study, greater improvement in angina frequency and quality of life, assessed by the Seattle Angina Questionnaire, was achieved by CTO PCI compared to optimal medical therapy. Furthermore, after successful CTO PCI, improvements in health status were similar in patients with both low and normal EF. CTO PCI can not only ameliorate symptoms of angina in patients with low EF but may also potentially improve EF in carefully selected populations. However, information regarding treatment of this high-risk population is lacking and large-scale studies targeting patients with severely reduced EF remain necessary.

Keywords: Chronic total occlusion; Ischemic cardiomyopathy; Percutaneous coronary intervention; Quality of life; Reduced ejection fraction; Viability testing.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
    1. Tajstra M, Pyka L, Gorol J, et al. Impact of chronic total occlusion of the coronary artery on long-term prognosis in patients with ischemic systolic heart failure: insights from the COMMIT-HF Registry. JACC Cardiovasc Interv. 2016;9:1790–7. - DOI
    1. Lee SW, Lee PH, Ahn JM, et al. Randomized trial evaluating percutaneous coronary intervention for the treatment of chronic total occlusion. Circulation. 2019;139:1674–83. - DOI
    1. • Werner GS, Martin-Yuste V, Hildick-Smith D, et al. A randomized multicentre trial to compare revascularization with optimal medical therapy for the treatment of chronic total coronary occlusions. Eur Heart J. 2018;39:2484–93. Findings from this study suggested improvement in quality of life assessed by the Seattle Angina Questionnaire (SAQ) in patients undergoing CTO PCI compared to medical therapy alone. - DOI
    1. •• Khariton Y, Airhart S, Salisbury AC, et al. Health status benefits of successful chronic total occlusion revascularization across the spectrum of left ventricular function: insights from the OPEN-CTO Registry. JACC Cardiovasc Interv. 2018;11:2276–83. Findings from this study suggested patients with low ejection fraction also experience large, sustained improvements in angina symptom burden, dyspnea, and overall quality of life following CTO-PCI.
    1. Safley DM, Grantham JA, Hatch J, Jones PG, Spertus JA. Quality of life benefits of percutaneous coronary intervention for chronic occlusions. Catheter Cardiovasc Interv. 2014;84:629–34. - DOI

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