SCIENTIFIC JOURNAL of the Hungarian Society of Cardiology

Recanalisation of a right coronary CTO using retrograde approach via homocoronary collateral

█ Case report

DOI: 10.26430/CHUNGARICA.2017.47.4.258

Komócsi András1, Pintér Tünde1, Kittka Bálint1, Horváth Iván1, Ili Renáta1, Katona András2, Ungi Imre2
1Pécsi Tudományegyetem, Klinikai Központ, Szívgyógyászati Klinika, Pécs
2Szegedi Tudományegyetem, Általános Orvosi Kar, II. sz. Belgyógyászati Klinika és Kardiológiai Központ, Szeged


Transcatheter revascularization of chronic total coronary occlusions (CTO) remains a challenging field of interventional cardiology. Successful recanalization may improve ventricular function, quality of life, and may decrease mortality. Careful patient preparation and advance planning of the intervention is inevitable in order to improve the success rate of the procedure.
We present coronary intervention of a patient with history of diabetes, hypertension, chronic obstructive pulmonary disease and an earlier coronary bypass operation. Before the recanalization of the CTO of the right coronary artery, viability of the inferior, inferolateral segments of the left ventricle was verified with magnetic resonance imaging. With the absence of transseptal or epicardial heterocoronary collaterals the retrograde CTO recanalization was performed through the proximal homocoronary collateral. We would like to present this case to demonstrate the main planning steps of CTO interventions including access site, guiding catheter, donor artery and interventional tool selection and present the main steps of the intervention.


click here to read the full article

click here to read the pdf