Περιορισμός εκτάσεως πειραματικού εμφράγματος του μυοκαρδίου δια θρομβολύσεως και μηχανικής υποβοηθήσεως

Abstract

Background, Thrombolytic therapy improves left ventricular ejectionraction and survival. The study was undertaken to evaluate the effectsof intraaortic balloon pump used in conjunction with reperfusion inreducing infarct size.Indication primary PCI : Is recommended inpatients with chest pain /discount < 12 h + persistentST – segmentelevation or previously undocumented left bundle branch block.As soonas possible and at any rate < 2 h from FMCd [ class a 1; levelb A; ref c83.84.94 PCI after Fibronolysis.Rutine urgent PCI is indicated after successful fibronolysis ( resolvedchest pain / discomfortand ST- segment elevation) Time from FMCwithin 24h [class I ;Level A; Ref 77-79]a = class of recommendationb= Level of evidencec= Referenced= < 90 min + patient present < 2h from symptoms on set and haslarge infract and Low bleeding risk.ESC/ EACTS Guidelines Table 14 Recommendations for percutaneuscoronary intervention in ST- segment elevation myocardial infartion.FMC= medical contact firstMI = myocardial infarctionPCI= percutaneus coronary interventionMethods. Twenty-two dogs were subjected to proximal left anterior descending coronary artery occlusion. In group 1 (n = 7) occlusionlasted for 6 hours. In group 2 (n = 6) 2 hours of occlusion was followedby reperfusion. In group 3 (n = 9) after 2 hours of occlusion the dogswere assisted with the intraaortic balloon pump throughout the 4 hoursof reperfusion. At the end of 6 hours the infracted myocardium of theleft ventricle was determined and expressed as percentage of themyocardium at risk.Results. In group 1, the infracted myocardium was 79.3 ± 9.9% of themyocardium at risk, inMyocardial Salvage by the Use of Reperfusion and intraaortic BalloonPump.Group 2,59.0 ± 19.9% (p < 0.05 versus group 1), and in group 3,37.1 ±16.7% (p < 0.001 versus group 1 and p< 0.05 versus group 2).Endocardial viability ratio was increased by ihe intraaortic. Balloonpump; in.group 1 it was 1.02 ± 0.14-m-group 2, 1.25 ± 0.24, and in group3, 1.47± 0.31 (p < 0.001-versus group 1 and p < 0.02 versus group 2).Conclusions. Reperfusion and intraaortic-balloon pump increased salvageof the ischemic myocardium over that achieved by reperfusion alone in acanine occlusion-reperfusion model.