Clinical efficacy of coronary angioplasty for totally occluded lesions in recent transmural myocardial infarction

: Percutaneous coronary angioplasty was used to treat the occlusive lesions responsible for prior myocardial infarction occurring 1-8 weeks previously. Angioplasty was successful in 31 of 33 patients' lesions. Follow-up angiography showed dilated lesions were patent (0-50% diameter stenosis) in 10 patients, mildly stenosed (51-74%) in 3, severely stenosed (75-90%) in 10, subtotally occluded in 2, totally occluded in 5 and one was lost to follow-up. By repeating angioplasty up to two times, the lesions became patent in 23 patients, mildly stenosed in one, totally occluded in 4, and 3 were lost to follow-up. Measuring the left ventricular function in 22 patients with patent lesions and one with mildly stenosed lesion showed the left ventricular ejection fraction was improved from 60 +/- 13.1 to 69 +/- 11.6% (p < 0.00005), and hypokinetic areas (from 18 +/- 15.1% of left ventricular wall to 11 +/- 9.9%, p < 0.05) and an akinetic area (from 11 +/- 12.5% to 4 +/- 7.3%, p < 0.002) were decreased. The findings indicate that angioplasty for totally occluded lesions within 12 weeks of infarction achieves satisfactory lesion patency and functional recovery of the infarcted myocardium.