Objective To assess the immediate- and long-term outcomes of stent supported coronary angioplasty in patients with severe left ventricular dysfunction. Methods Seventy-four consecutive patients with angiographic left ventricular ejection fractions ≤40% underwent percutaneous coronary angioplasty, including 61 (81%) with stent back-up. Clinical follow-up (29.1±22.9 months) data were obtained in all clinically successful patients. Results Angiographic success was achieved in 120 (89.5%) of 134 lesions. Clinical success was obtained in 66 (89.2%) patients with 1.4% procedure related mortality, 2.7% myocardial infarction and zero need of emergent bypass surgery. NYHA class reduction ≥1 was seen in 29 (73%) of 40 successfully treated congestive heart failure patients at 6 months after the procedure. During long-term follow-up, 58 (87.9%) of 66 patients with clinical success were alive, including 44 (68.6%) free from cardiac events. Conclusions Patients with severe left ventricular dysfunction treated with stent supported PTCA experience a high rate of success, low procedure related mortality and satisfactory long-term survival.%目的 评价PTCA结合支架治疗冠心病左室功能不全的近期、远期疗效.方法 连续74例冠心病合并左室射血分数≤40%行PTCA治疗,其中61例（81%）在支架支持下进行,所有治疗成功者随诊 29.1±22.9月.结果 PTCA 结合支架治疗的病变成功率为89.5% (120/134),病例成功率为89.2% (66/74).围术期病死率为1.4%,心肌梗塞发生率为2.7%,无1例需行急诊冠状动脉搭桥术.44例合并心力衰竭治疗成功者, 29例(73%)术后6月NYHA分级下降≥1.长期随诊期间,58例(87.9%)治疗成功者存活,其中44例(68.6)无任何心脏事件存活.结论 PTCA结合支架治疗冠心病左心功能不全的成功率高,围手术期死亡率低,远期生存率高.
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