The necessary conditions of chronic total occlusion of all three coronary vessels:the relationship between portions of coronary occlusion and collateral vessels Ikuo Moriuchi 1 , Junichiro Mifune 1 , Senshu Hifumi 1 , Yosifumi Takahashi 1 , Tetsuo Suematsu 1 , Tatsuaki Murakami 1 , Shinji Ozawa 1 , Takashi Tanaka 1 1Department of Medicine, Fukui Cardiovascular Hospital Keyword: 冠動脈三枝慢性完全閉塞(chronic total occlusion of three coronary vessels) , 側副血行路(collateral) , 狭心症(angina pectoris) pp.659-663
Published Date 1990/7/15
DOI https://doi.org/10.11477/mf.1404900176
  • Abstract
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This study was performed to define the conditions present in chronic total occlusion of all three coro-nary vessels.

Each left descending coronary artery (LAD), left circumflex branch (LCX) and right coronary artery (RCA) was totally occluded angiographically in 5 patients (mean age 64, male 3, female 2).

Four of them had history of myocardial infarction. Anginal type was effort angina in all patients, and two cases showed unstable angina.

Good collateral supply was found in the distal por-tions of occluded vessels from proximally located branches, such as Conus branch, Right ventricular branch, Septal branch and Left atrial circumflex branch. Almost all of the occlusions were located at mid portions (13/15: mid, 2/15: proximal). Ejec-tion fractions (EF%) of the 5 patients were 70%, 69 %, 60%, 28% and 22% respectively. EF was corre-lated with the degree of collateral supply and one of them (22%) ended in sudden death.

These findings suggest that the mid portion occlu-sion, good collateral supply and a long history of angina pectoris are important factors involved in chronic total occlusion of the three coronary vessels.

Copyright © 1990, Igaku-Shoin Ltd. All rights reserved.


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