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Submitted by Dr. Yasser Mokhtar, MD. Dept. of internal medicine. School
of medicine, University of South Dakota.
12th May, 2001
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Percutaneous in-situ coronary venous arterialization is a new less invasive alternative to CABG.
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Percutaneous in-situ coronary venous arterialization (PICVA)
is gaining alot of attention recently. Especially after its initial success
in saving the life of a patient suffering from cardiac
infarction who was not candidate for
CABG. However, as successful and promising as everything may seem
it is way too early to decide whether it shows a survival benefit over
traditional CABG.
Pros and Cons
First of all this procedure has only been used on one human being in
Germany and was done almost one year ago. However, it has been tested
on pigs and has showed a survival benefit over
CABG.
Secondly, the technique uses the
coronary veins which are rarely diseased as opposed to other percutaneous
techniques which use the saphenous vein or other arterial conduits that
are the seat of
plaques.
Lastly, the technique and devices used are still under development.
Candidates for PICVA
Patients who can potentially benefit from the procedure include those
who are candidates for various types of laser-based transmyocardial laser
revascularization procedures; re-do
CABG patients; patients with chronic
total occlusions; and patients who are candidates for
gene therapy.
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