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 to 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.
Dr. Tamer Fouad, MD
MB, BCh, MSc Internal Medicine.
Consultant of Hematology - Oncology.