Chronic Total Occlusion Interventions in Patients with Reduced Ejection Fraction

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

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.

Publication types

  • Review

MeSH terms

  • Angina Pectoris / therapy
  • Chronic Disease
  • Coronary Occlusion* / surgery
  • Humans
  • Percutaneous Coronary Intervention* / adverse effects
  • Prospective Studies
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Registries
  • Risk Factors
  • Stroke Volume
  • Treatment Outcome
  • Ventricular Dysfunction, Left* / complications