This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Voci, P. Articles by Romeo, F. Search for Related Content PubMed PubMed Citation Articles by Voci, P. Articles by Romeo, F.

Coronary recanalization in anterior myocardial infarction

The open perforator hypothesis¹

Paolo Voci, MD, PhD^*,*, Enrica Mariano, MD^*, Francesco Pizzuto, MD^*, Paolo Emilio Puddu, MD, FESC, FACC^* and Francesco Romeo, MD, FESC, FACC

^* Section of Cardiology, La Sapienza University, Rome, Italy
Section of Cardiology, Tor Vergata University, Rome, Italy

View larger version (101K): [in a new window]   Figure 1 Different levels of recanalization as assessed by high-resolution transthoracic color-Doppler echocardiography after anterior myocardial infarction. (A) Neither the left anterior descending (LAD) nor the perforators are imaged in a patient with failed reperfusion and occluded LAD at angiography. (B) Patent LAD without perforating branches. (C, D) Imaging of perforating branches (non-full-thickness recanalization). (E, F) Full-thickness recanalization.

View larger version (138K): [in a new window]   Figure 2 Transthoracic Doppler shows a wide variability of diastolic flow velocity, ranging from 15 to 40 cm/s, and flow in opposite direction in a perforating branch (right lower panel). LAD = left anterior descending.

View larger version (32K): [in a new window]   Figure 3 Regression lines show better correlation between recanalization score and wall motion score index and ejection fraction at follow-up, compared with Thrombolysis In Myocardial Infarction (TIMI) flow.

View larger version (34K): [in a new window]   Figure 4 Regression lines show good correlation between recanalization score and end-diastolic volume index (EDVI) and end-systolic volume index (ESVI) at follow-up, indicating a positive impact on left ventricular remodeling, whereas with Thrombolysis in Myocardial Infarction (TIMI) flow there was no difference between the regression lines of baseline versus follow-up of EDVI and ESVI.