PT104 Percutaneous Treatment of Refractory Heart Failure Secondary to Old Myocardial Infarction by Anteroapical Splinting Stent in the Left Anterior Descending Coronary

1 , H. Gutierrez-Leonard 1 , H. Garcia-Velazquez 1 , A. Hernandez-Casas 1 , R. Aguilar-Oliva 1 , B. Fuentes-Flores 1 Methods: A total of 48 patients between 62 and 74 years old, 31 men and 17 women. We randomized, the first group was the experimental, group A and group B, the control group, each one with 24 patients. All patients suffered refractory heart failure with left fraction ejection less than 30% in class III and IV (NYHA). Transthoracic echocardiogram was performed at admission, 6 and 12 months, nuclear imagine thallium cardiac ventriculog- raphy was done, all these studies shows no viability in this territory and coronary angi- ography was done the next day. All patients suffered from LAD desease only, and the vessel was patent in every one. We deliver bare metal stents from distal to proximal, the stents used are from 2.5mm to 3.5 mm in diameter and 28 to 36 mm long. All stents were spliced together with 5 mm each from distal to proximal just in the main lession. All patients are reassessed clinicaly each month to determine their functional class (NYHA) and echocar- diography study was performed at 6 and 12 months. Results: Functional class improves in all the patients from the experimental group (24 patients), 21 patients pass to II functional class and only 3 patients stayed in III functional class, actually 2 patients died, the first one died at the next 8 months and the second one at the 18 months. From the control Group 6 patients died in the first year, in the next six months 3 more patients died and all 6 patients stayed in III and the rest in IV functional class. The left fraction eyection improve in a average 5%, but in all the patients the ter- apeutic medication were reduced. From the control group we found that 80% of the pa- tients were hospitalized around 3 or 4 times per year and in the experimental grupo only 10%. Conclusion: This technique is effective for the treatment of patients with refractory heart failure, besides being easy to apply, during the procedure there were no deaths, and functional class improved significantly for patients in a period of 6 months until these periode. This Tecnique demostrate the mortality decrease in patients with refractory cardiac failure.