Objectives: The effectiveness of percutaneous transluminal coronary intervention (PCI) was evaluated for chronic total occlusion (CTO) assessed as non-viable by myocardial scintigraphy.
Methods: In the period from January 2003 to October 2006, 17 patients who had successful reopening of the artery through revascularization by PCI for CTO assessed as non-viable were classified as the P group, and 30 patients whose course was observed while undergoing medical therapy after being assessed as nonviable formed the M group. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDV) and SD/chord were measured in both groups before the procedure and at the chronic phase (mean 6.2 months). The incidences of chronic cardiac events at mean 20.5 months were compared.
Results: No significant differences were revealed between the two groups in LVEF and LVEDV prior to the procedure. No significant differences between the groups were revealed for Delta LVEF or Delta LVEDV. A significant improvement (p < 0.05) was revealed for SD/chord in the P group with - 1.50 +/- 0.25 before the procedure, becoming - 1.34 +/- 0.33 in the chronic phase, but the M group revealed no significant change. No significant difference was revealed in the avoidance of chronic cardiac events with 94.1% for the P group and 86.0% for the M group.
Conclusions: Improvement in local left ventricular wall motion by revascularization is possible even in patients with chronic total occlusions assessed as non-viable by myocardium scintigraphy.