ANGIOGRAPHIC STUDY OF CORONARY-ARTERY DISEASE PATIENTS RECEIVING CIRCULATORY ASSISTANCE BY INTRA-AORTIC DIASTOLIC COUNTER-PULSION

In patients receiving circulatory assistance by intra-aortic counter-pulsion for myocardial infarction, angiography may be carried out by the retrograde femoral route. It should include left ventriculography makes it possible to assess the number of segments which contract and to draw a correlation between the kinetics of a segment and its vascularisation. Vascular studies should be carried out at the time of maximum effect of the pump, i.e. from the 18th hour onwards. Indications for angiography are as follows: isolated or mechanical cardiogenic shock, early recurrence of infarction, refractory left ventricular failure and persistent arrhythmias. In cardiogenic shock and refractory left ventricular failure, the coronary lesions are diffuse. All our patients died. By contrast, in the group with early recurrence of infarction or persistent arrhythmias surgical treatment is often possible.