Ignorance based Primary PCI : A landmark article that couldn ’ t correct our coronary Intellect !
How often you assess the success of Primary PCI with degree of ST segment regression or resolution ?
I posed this query to a freshly hatched , Intelligent and energetic cardiologist in an upscale dedicated heart care center.
He said, “No, we don’t .We always go with TIMI flow in IRA .TIMI 3 flow with less than 30% narrowing of IRA is success, that’s it ! He continued ,very often ,we don’t even Insist to take serial ECGs after the procedure . . . forget about analysing ST segment ! His body language seemed to suggest, he didn’t expect such a question (Silly !) from me , talking about ECG in this era of hyper Interventionism where we literally live within the coronary artery !
What a grave error in coronary cognition ? . . . thats commited day in day out of cath lab all over the globe !
TIMI flows across IRA lesion tell more about epicardial patency while the humble ECG reveals the true myocardial reperfusion.
So ,which will you use for assessment for successful reperfusion ? Ideally both , right !
But , as of 2017 ST segment regression is not considered worthy to define success of pPCI by the all powerful world scientific cardiology community .This is unfortunate (Or Intentional ?) we have ignored this Inspite periodic research papers showing the importance of the same. (Link to this land mark Brodie BR AJC 2005)
Do you know , none of the trials that celebrated the superiority of primary PCI in the last t...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: dr s venkatesan Tags: Uncategorized pPCI primary pci stemi st segment regression more important than ira patency st segment regressionafter ppci timi blush score timi three flow Source Type: blogs
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