Left main coronary in-stent intimal hyperplasia and hemodynamics as detected by contrast-enhanced transesophageal echocardiography.

Roberto Baglini, Andrea Amaducci, Giuseppe D'Ancona

Department of Interventional Cardiology, Ismett/UPMC, Palermo, Italy. baglinir@gmail.com

Echocardiography (Mount Kisco, N.Y.) 2013 Mar

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In-stent hemodynamics were studied by transesophageal echocardiography (TEE) in a group of 54 patients after left main coronary artery stenting, during a 6-month follow-up. TEE was performed within 24 hours after stenting and at 1- and 3-month follow-up. Pulsed wave and color Doppler signals were enhanced by IV administration of Levovist. Angiographic immediate success was obtained in all patients. No in-hospital death occurred. Ten patients (18.4%) complained of recurrent angina at the follow-up of 4.8 ± 1.2 months. Both TEE and coronary angiography confirmed in-stent restenosis in all. Thirty-nine patients (68.5%) remained symptoms free. Mean late loss in these patients was 0.69 ± 0.20 mm. A linear significant positive relation between mean late loss values and diastolic coronary velocity (r: 0.89, P < 0.001) was found. After 3- and 6-month follow-up, PDV showed a significant increase in comparison with basal values (0.7 ± 0.3 and 0.6 ± 0.26 vs. 0.32 ± 0.2 cm/sec, P < 0.01). All patients with restenosis showed a significant increase of diastolic coronary velocity in comparison with basal values (2.89 ± 0.25 cm/sec, P < 0.001). TEE can predict the development of in-stent intimal hyperplasia in patients with unprotected left main coronary artery stenting. © 2012, Wiley Periodicals, Inc.

Citation

Roberto Baglini, Andrea Amaducci, Giuseppe D'Ancona. Left main coronary in-stent intimal hyperplasia and hemodynamics as detected by contrast-enhanced transesophageal echocardiography. Echocardiography (Mount Kisco, N.Y.). 2013 Mar;30(3):317-23